01102024-2EQUEST FOR PUBLIC RECORDS
REQUESTER INFORMATION
Full Name : Date:
Company Name:
Mailing) Address: City/State/Zip Code:
Phone number: Email:
Preferred method of contact in the event of questions:
DESCRIPTION OF REQUESTED RECORD(S): (Describe the specific public record(s) e.g., date, type, time period covering
documents requested, etc.)
SIGNATURE OF REQUESTER
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
STEP 1: 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; tbass@anaheim.net; fax (714) 765-4105.
STEP 3: WAIT to receive a response from the City. The City shall determine within 10-days from receipt of a public reForGs reTuest,
Zhether the reTuest, in ZhoOe or in part, seeNs Fopies of GisFOoseaEOe puEOiF reForGs in possession of the City >GC 7927.535(a)@.
3Oease note that if you are reTuestinJ the opportunity to inspeFt reForGs, you ZiOO Ee reTuesteG to maNe an appointment to return at a
Oater Gate time to YieZ the GoFuments.
CharJes for the GireFt Fost of GupOiFation ZiOO appOy. Documents will not be copied until payment has been received. If payment is
not reFeiYeG Zithin 20 Gays after inYoiFe is sent, you may Ee reTuireG to suEmit a neZ reTuest. 3Oease see EaFNsiGe for aGGitionaO
information.
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 documents.
I wish to inspect City records Will Pick-Up Records Please Mail
Please note that information contained in any PRA request is a public record and may be subject to public inspection
pursuant to the CaOifornia 3uEOiF 5ecords Act.
Request for Public Records
002 Rev. 0/2
INSTRUCTIONS FOR REQUESTING PUBLIC RECORDS
Government Code Section 7920.000 et seq.)
1. To expedite your request, requests for records should be in writing. A Public Records Request
Form can be submitted online at www.anaheim.net/cityclerk, downloaded and mailed or faxed to:
Office of the City Clerk, 200 S. Anaheim Blvd., Suite 217, Anaheim, CA 92805; fax (714) 765-4105.
You may also request a form be mailed to you by contacting the Office of the City Clerk at (714)
765-5166. Please note that information contained in a request is a public record and may be subject
to public inspection pursuant to the California Public Records Act.
2.If your request is to inspect rather than receive copies, the responsive Department will make an
appointment for a reasonable future date/time for such records. This is necessary to allow time to
gather and review documents for compliance with the provisions of the California Public Records
Act.
3.Requests (inspection and/or copies) must be for records in the possession of, prepared, owned, used,
or retained by the City of Anaheim [Gov. Code §7920.530)] and must be for clearly identifiable
records. City staff is available to assist you in identifying those records in the Department/City’s
possession. The City is not required by law to create a record or list from an existing record. Copies
will not be provided if disclosure is exempt in accordance with State law.
4.The City will make every effort to provide the documents in a reasonable time. You will be notified
within ten (10) days from the date of your request:
Whether the City has records responsive to your request
Whether the City has records responsive to your request, but which are exempt from
disclosure and the reasons for exemption
Whether the City requires an extension of time to determine whether it has records
responsive to your request
5.Copy charges are enumerated on the City Clerk’s Fee Schedule as adopted by the City Council. The
standard charge for copies of any specifically described and identified public records not exempt
from disclosure is $0.15 per page. Color copies are $0.20 per page. Records copied to CD or flash
drive are $10.00 per CD or flash drive. Records stored by the City in electronic format will be
provided in the same electronic format when requested by any person. The City is not required to
produce records in an electronic format when the requested records are not available in electronic
format at the time of the request. Mailing charges will apply, if necessary. Fee schedules are
approved by City Council and are available upon request.
6.The Office of the City Clerk will provide an invoice for charges due. These charges are due and
payable upon receipt of the invoice. Upon remittance of the invoice amount, the records request will
be copied and sent to the requestor. If arrangements for payment and production are not made
within twenty (20) days of the date of the City’s response, a new request may have to be submitted.
7.For further information, please refer to the California Public Records Act (California Government
Code §7920.000 et seq.) or contact the Office of the City Clerk, 200 S. Anaheim Blvd., Suite 217,
Anaheim, CA 92805; Phone: (714) 765-5166.
Request for Public Records
002 Rev. 0/2