Open Public Records Act Request Form - Brick Township Municipal Utilities Authority Page 2
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1
2
3
4Tracking Information
Final Cost
Disposition Notes
Custodian: If any part of request cannot be
Est. Document Cost
Total
Tracking #
delivered in seven business days,
Deposit
Rec’d Date
detail reasons here.
Est. Delivery Cost
Balance Due
Ready Date
Est. Extras Cost
Balance Paid
Total Pages
Records Provided
Total Est. Cost
Deposit Amount
Estimated Balance
In Progress
-
Open
Deposit Date
Denied
-
Closed
Filled
-
Closed
Partial
-
Closed
Custodian Signature
Date
DEPOSITS
The custodian may require a deposit against costs for reproducing documents sought through an anonymous request whenever the custodian
anticipates that the documents requested will cost in excess of $5 to reproduce.
Where a special service charge is warranted under OPRA, that amount will be communicated to you as required under the statute. You have
the opportunity to review and object to the charge prior to it being incurred. If, however, you approve of the fact and amount of the special
service charge, you may be required to pay a deposit or pay in full prior to reproduction of the documents.
YOUR REQUEST FOR RECORDS IS DENIED FOR THE FOLLOWING REASON(S):
(To be completed by the Custodian of Records – check the box of the numbered exemption(s) as they apply to the records requested. If
multiple records are requested, be specific as to which exemption(s) apply to each record. Response is due to requestor as soon as
possible, but no later than seven business days.)
N.J.S.A. 47:1A-1.1
Inter-agency or intra-agency advisory, consultative or deliberative material
Legislative records
Law enforcement records:
Medical examiner photos
Criminal investigatory records (however, N.J.S.A. 47:1A-3.b. lists specific criminal investigatory information which must be
disclosed)
Victims’ records
Trade secrets and proprietary commercial or financial information
Any record within the attorney-client privilege
Administrative or technical information regarding computer hardware, software and networks which, if disclosed would jeopardize
computer security
Emergency or security information or procedures for any buildings or facility which, if disclosed, would jeopardize security of the
building or facility or persons therein
Security measures and surveillance techniques which, if disclosed, would create a risk to the safety or persons, property, electronic
data or software
Information which, if disclosed, would give an advantage to competitors or bidders
Information generated by or on behalf of public employers or public employees in connection with:
Any sexual harassment complaint filed with a public employer
Any grievance filed by or against an employee
Collective negotiations documents and statements of strategy or negotiating
Information that is a communication between a public agency and its insurance carrier, administrative service organization or risk
management office
Information that is to be kept confidential pursuant to court order
Certificate of honorable discharge issued by the United States government (Form DD-214) filed with a public agency
Social security numbers
Credit card numbers
Unlisted telephone numbers
Drivers’ license numbers
Certain records of higher education institutions:
Research records
Questions or scores for exam for employment or academics
Charitable contribution information
Rare book collections gifted for limited access
Admission applications
Student records, grievances or disciplinary proceedings revealing a students’ identification
Biotechnology trade secrets N.J.S.A. 47:1A-1.2
Convicts requesting their victims’ records N.J.S.A. 47:1A-2.2
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