01092024-6ity of Anaheim
Office of the City Clerk
200 S, Anaheim Blvd., Suite 217
Anaheim, CA 92805
17 t4l 7 65-5166 . fax (714) 76s-4705
www.?,mh,eim.neJ
ReOueST F PueLrc Reconos
REQUESTER INFORMATION
Full Name , fv lcr W i) h t\ivt Date:
Company Name:
Mailing)Add."rs crty6igltdzipcoae: Anlj^Vpt'/t, (fi di'?b7)
Preferred method of contact in the event of questions:
DESCRIPTION OF REQUESTED RECORD(S): (Describe the specific publio record(s) e.g., date, type, timo period oovering
dooumonts requosted, eto,)
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I understand that I will be contacted once documents have been identified. Ifproduction ofrecords is reqttested, an
estimated cost will be provided to me and I agree that I will be required to subrnit payment for duplication costs (and
mailing) prior to the production of the requested documeuts.
I I *irt to inspect City records S*u,."t-up
Records ! PleaseMail
Please note that information contained in any PRA request is a public record
pursuant to the California Public Records Act.
Request for Public Records
CC 1"002 Rev. 01/23
l- e,'- z-o24
STIP 1: COMPLETE all lields on this fonn. 'Ihis lbrm is to thcilitate and expedite the processing of your public records request.
Describe identifiable records in the possession ofthe City; your request must be sufficiently focused and specific to allow
fte City to locate the requested record(s).
STEP 2: SUBMIT cornpleted fonn by mail, fax, email, or in person to Custodian of Records, Otfrce of the City Clerk,
200 S. AnaireirnBlvd., Suite2l7, Anaheim, CA 92805; tbass(a)anaheim.net,fax (114)165-4105.
STI-IP 3; EII to receive a respollse from the City. The City shall detemrine within lO-days from receipt of a public records request,
wlrether the request, in whole or in part, seeks copies of discloseable public records in possession of the City IGC 7927 .535(a)],
Please note that ifyou are requesting the opportunity to inspect records, you rvill be requested to make an appointrnent to return at a
later date/tirne to vierv the docurnents.
Charges for the direct cost of cluplication will apply. Documents will not be copied until payment has bcen receiyed. If pavment is
uot received within 20 days atter invoice is sent, you may be required to submit a new request. Please see backside for additional
be subject to public inspection
RE OF REQUESTER