Public Records Request Form - Cuyahoga Community College

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Public Records Request Form
Contact Information:
Mailing Address:
City, State, Zip:
Phone Number:
Fax Number:
Email Address:
Public Record(s) Requested:
A requester need not make a request for public records in writing, or identify himself/herself when making
a request.
Method of Delivery:
It is the policy of Cuyahoga Community College to provide the responsive record(s) via electronic delivery, either as an
Adobe pdf attachment to an email or on a CD-R, depending on the size and volume of the response. If you would prefer
to receive the records via another delivery method, please indicate below:
I am acceptable to receiving the responsive record(s) via electronic delivery as described above.
I want to view the responsive record(s) at Cuyahoga Community College at no cost. (Please note that if copies
are requested at the viewing, a copy charge of $0.05 per page will be assessed.)
I want to purchase copies of the responsive record(s). Copied documents may be picked up or mailed upon
receipt of payment. Paper copies are $0.05 per page. Mailed documents are subject to postage fees.
For Cuyahoga Community College Use Only:
Total Number of Responsive Pages:
Cost for Production:
Not Approved
Paid $ __________ on _____ / _____ / _____
Records Produced on _____ / _____ / _____ via _________________________________________________
Please Note: College public records are in various locations throughout College campus and administrative office locations. The College requests
that a reasonable amount of time be expected for responding to any request to copy or inspect records. The College may require additional time to
process more difficult or voluminous requests and, if so, an estimated time frame for response will be provided to the requestor. If you would like
additional information on Ohio’s Public Records Act click here.


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Parent category: Business