Public Records Request Form - City Of Willits printable pdf download

PUBLIC RECORDS

REQUEST FORM

Please refer to back of this form for information regarding California

Public Record Act requests. (Govt. Code Section 6250 et seq.)

City Clerk’s Date Stamp

PLEASE PRINT CLEARLY

General Information

To expedite your request and to eliminate opportunities for error, please complete this form with as much detail as possible and identify specifically the records you are

requesting. Requests should reasonably describe identifiable records prepared, owned, used or retained by Willits City Hall. The City Clerk is available to assist you in

identifying the records within control of City Hall based on your description. City staff is not required by law to create a new record or list from an existing record.

Please note that if you are requesting the opportunity to inspect records stored at this office, City staff must be given time to locate and review documents that are

responsive to your request in order to comply with the provisions of the Public Records Act. You will, therefore, be requested to make an appointment to return at a later

date to view the documents.

You will be charged the direct cost of duplication for any documents of $0.25 per page and/or $15.00 for data DVD or CD, whichever had been requested. You will be

contacted with a count of the number of pages to be copied and their cost prior to copying. Payment will be required in full prior to releasing the documents.

Section 1 – Records Requested

I wish to:

 Review the records only

 Obtain copies of the following public records:

(Please list each document, file or record separately)

Time Period Covering Documents Requested:

Section 2 – Requester Contact Information

Name of Requesting Party:

Business Name/Organization:

Mailing Address:

City:

State: