02052024-2REQUEST FOR PUBLIC RECORDS
200 S. Anaheim Blvd., Suite 217
Anaheim, CA 92805
(714) 7f5-SIff a fax (714) 7f5-,411115
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.
Describeidentifiable 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. (714) 765-5166; thassOingheim.net; fax (714) 7654105. -
STEP 3: _WATT to receive an invoice for responsive records. The City shall determine within 10-days from receipt of a public
records request, whether the request, in whole or in part, seeks copies of discloseable public records in possession of the
City [GC 6253(c)]. Please note that if you are requesting the opportunity to inspect records, you will be requested to maki
an appointment to return at a later date/time to view the documents.
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
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DESCRIPTION OF REQUESTED RECORD(S): (Describe the specific public record(s) e.g., date, type, time period covering
documents requested etc) CA
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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 documents.
I wish to inspect City records Will Pick -Up Records Please Mail
Please note that information contained in any PRA reque is , public recordapd may'be subject to public inspection pursuant to the
CA Public Records Act.
-`�IGNATURE OF REQUESTER
(Goverriment Code Section 6250 et seq.)
0 Whether the City has records responsive to your request, but which are exempt from
disclosure and the reasons for exemption
0 Whether the city requires an extension of dine to determine whether it has records
responsive, to your 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 rernittance of the invoice amount, the records request. -,viU
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 rn-ay have to be submitted.,
7. For further information, please refer to the California Public Records Act (California Government
Code §6250 et seq.) or contact the Office of the City Clerk, 200 S. Anaheirn Blvd, Suite 217,
Anaheim, CA 92805; Phone: (714) 765-5166.