02022024-5City of Anaheim REQUEST FOR PUBLIC RECORDS
Office of the City Clerk
200 S. Anaheim Blvd., Suite 217
Anahelm, CA 92805
(714) 765-5166 * fax (714) 765-4105
www.anahe�m.net
Charges for the direct cost of duplication will apply. Documents will not be copied until payment has been received. If
payment is not received within 10 days after invoice is sent, you may be required to submit a new request. Please see
backside for additional information.
REQUESTER INFORMATION
Full Narne Date:
'Company Name:
(Mailing) Addre —City/State/Zip Code: -Aw6qh7�w)i
Phone numberl ail
Preferred method of contact in the event of questions:Fm
DESCRIPTION OF REQUESTED RECORD(S): (Describe the specific public record(s) e.g., date, type, time period covering
documents requested etc)
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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 d7ocellits,
[] I wish to inspect City records Will Pick -Up Records Please Mail
Please note that information contained in any PRA request is a publW'- record and mayv4e subject to public inspection pursuant to the
CA Public records Act. oN I /p
RE 0F1 REQUESTER
SIGN ,
I,N5,TRUCTIQ E E-511-MUDWILUKIWIM-MI
_NSFQR,R-%—VAL 71
(Government Code Section 6250 et seq.)
1. To expedite your request, requests for records should be in vmidng. A Pubhc Records Request
Form can be submitted onfineat Iyaov.aug jaeinLaet, ,downloaded 211 d mailed of faxed to:
Office of the City Clerk, 200 S, Anaheim Blvd., Anaheim CA 92805; fax (714) 765-4105. You may
also request a form be mailed to you by contacting the City Clerk's Office at (714) 765-5166. 'Please
note that- information contained in a request is a public record mid may be subject to public
inspection pursuant to the CA Public.Records Act.
2. If your request is to inspect rather than receive copies,'the responsive. Deparffnent vrU make, an
appointment for a reasonable future date, /time for such records. This is necessary to allow time to
gather and reviev, documents for co ph with the provisions of the Public Records Act.
3. Requests (inspection and copies) most be for records in the possessions of, prepared, owned, used,
or retained by the City of. nahei [Gov. Code §6252(e)] and must be for clearly identifiable records.
City staff is available to assist you in identifying those records in the. Department/Citys 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 effbit to provide the documents in a reasonable time. You will be notified
witb ten (10) days from the date of your request:
Whether the City has records responsive to your request and the page count to produce such
records
Whether the City has records responsive, to your request, but which are exempt Crows
disclosure and the reasons for exemption
Whether the city requires an extension of tirne 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 (RES-
2018-075). The standard ch-arge for copies of any specifically described and identified public records
not exempt from disclosure is $0.15 per page. Color copies ate $0.20 per page. Records copied to
CD are $10.00 per CD, Records stored by the City in electronic fomiat will be provided. in the same
electronic format hen requested by any person. The City is not required to produce records in an
electrorac format when the requested records are not avaliable in electronic format at the time of the
reqsiest. Mailing charges -%U apply, if necessary. Fee schedules are approved by City Council and aix
available upon request,
6. The Office of the City Clerk will provide an invoice for chatges due. These charges are, due and
payable upon receipt of the invoice. Upon remittrarce of the invoice amount, the records request will
be copied and sent to the requestor, If ravage eats for payment and production are not made
,writhin twenty (20) days of the date of the Citys response, a new request may have to be submitted.
7, For farther information, please refer to the Califomia Public Records Act (California Govermnent
Code §6250 et seq.) or contact the Office of the City Clerk, 200 S. Anaheim Blvd., Suite 217,
Anaheim, CA 92805; Phone: (714)765-5166.