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2024-01-09 12:56:14 UTC+14
From: Bianca Rojas
City of Anaheim
Office of the City Clerk
.\. - 200 S. Anaheim Blvd., Suite 217
' Anaheim, CA 92805
(714) 765-5166 • fax (714) 765-4105
www.anaheim.net
REQUEST FOR PUBLIC RECORDS
STEP I: COMPLETE all fields on this form. This form is to facilitate and expedite the processing of your public records request.
Describe identifiable records in the possession of the City; your request must be sufficiently focused and specific to allow
the City to locate the requested record(s).
STEP 2: SUBMIT completed form by mail, fax, email, or in person to Custodian of Records, Office of the City Clerk,
200 S. Anaheim Blvd., Suite 217, Anaheim, CA 92805; thassO.-analtchn.net; fax (714) 7654105.
STIR' 3: WAIT to receive a response from the City. The City shall determine within I0-days from receipt ofapublic records request,
whether the request, in whole or in part, seeks copies of discloseablc public records in possession of the City [GC 7927535(a)].
Please note that if you are requesting the opportunity to inspect records, you will be requested to snake att appointment to return ata
later date/time to view the documents.
Charges for the direct cost of duplication will apply. Documents will not be copied until payinent has been received. If payment is
not received within 20 days after invoice is sent, you may be required to submit a new request. Please see backside for additional
REQUESTER INFORMATION
Full Name: Cynthia Vega - Legal Rep Date: 01/08/2024
Company Name:
Avrek Law firm
(Mailing) .address: City/State/Zip Code: Newport Beach, CA 92660
Phone number: Email:
Prefoxed method of contact in the event of questions:
email or call
DESCRIPTION OF REQUESTED RECORD(S): (Describe Elie specific public record(s) e.g., date, type, time period covering
documents requested, e(c.)
We are needing help in locating a police report, incident report and or any type of report of an Biyclist V Auto accident. Mere is
the information for client states she was riding her bike north on Harbor to Ball Road close to Chevron gas station. Client states
defendant was entering gas station and did not see client. Client states she was unable to slow down and collided into defendant
vehicle. Date of accident 12/20/2023 at 5:30PM Wed.
Our clients info:
Veronica Valdez
DOB: -
naheim, CA 92805
DL#-
I understand that I will be contacted once documents have been identified. If production of records is requested, an
estimated cost will be provided to me and I agree that I will be required to submit payment for duplication costs (and
mailing) prior to the production of the requested doCUM tS.
1 wish to inspect City records Will Pick-ilp Records E] Please Afail
Please note that information contained in any PRA request is a public record and may be subject to public inspection
pursuant to the California Public Records Act.
Request for Public Records
CC 1002 Rev. 01/23
Uwafu,o, Vega,
SIGNATURE OF REQUE.. TER