Fillable Form Mv-4 - Government Records Request Form (Page 2 of 2) in pdf

New Jersey Open Public Records Act (N.J.S.A. 47:1A-1 et seq.)

State Law requires that in order to request government records, your must complete, sign and date this request form and

deliver it in person or by mail during regular business hours to the appropriate custodian of the record requested. Your request

is not considered filed until the request form has been received by the appropriate custodian of the record requested. If you

submit the request form to any other officer or employee of the Motor Vehicle Commission that officer or employee does not

have the authority to accept your request form on behalf of the Commission and you will be directed to the appropriate

custodian.

Descriptions of the divisions and agencies of the Department of Transportation can be found at

If you submit a request for access to government records to someone other than the appropriate custodian, do not complete the

Motor Vehicle Commission request form, or attempt to make a request for access by telephone or fax, the Open Public Records

Act and its deadlines, restrictions and remedies will not apply to your request.

The fees for duplication of a government record in printed form are listed on the front of this form. We will notify you of any

special charges, special service charges or other additional charges authorized by State law or regulation before process your

request. Payment shall be made by cash, check or money order payable to the Motor Vehicle Commission.

By State Law, a custodian must deny access to a person who is convicted of an indictable offense in New Jersey, any other

state, or the United States, who is seeking government records containing personal information pertaining to the person’s victim

or the victim’s family.

By law, the Commission must notify you that it grants or denies a request for access to government records within 7 business

days after the custodian of the record requested receives the request, provided that the record is currently available and not in

storage or archived. If the record requested is not currently available or is in storage or archived, the custodian will advise you

within 7 business days when the record can be made available and the estimated cost. You may agree with the custodian to

extend the time for granting or denying your request or making records available.

You may be denied access to a government record if your request would substantially disrupt agency operations and the

custodian is unable to reach a reasonable solution with you.

If the Commission is unable to comply with your request for access to a government record, the custodian will indicate the

reasons for denial on the request form and send you a signed and dated copy.

Except as otherwise provided by law or by agreement with the requestor, if the custodian of the record requested fails to

respond to you within 7 business days of receiving a written, signed request form, the failure to respond will be considered a

denial of your request.

If your request for access to a government record has been denied or unfilled within the time permitted by law, you have a right

to challenge the decision by Motor Vehicle Commission to deny access. At your option, you may either institute a proceeding in

the Superior Court of New Jersey or file a complaint in writing with the Government Records Council (GRC) in the Department

of Community Affairs. You may contact the GRC by toll-free telephone at 866-850-0511, by mail at PO Box 819, Trenton, NJ

08625, by e-mail at grc@dca.state.nj.us, or at their web site at The Council can also answer other

questions about the law.

10. Information provided on this form may be subject to disclosure under the Open Public Records Act.

Division

Mail Address

Street Address

Floor

City

Zip

Phone

Form Mv-4 - Government Records Request Form Page 2