02262024-8City oof f Anaheim REQUEST
Office the City Clerk
200 S. Anaheim Blvd., Suite 217
Anaheim, CA 92805
(714) 765-5166 a fax (714) 765-4105
www.anaheim.net
is
FOR PUB. Llekk'ORDS
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 it
the City to locate the requested record(s).
STEP 2: SUBAUr.rompleted form by mail, fax, email or in person to Custodian of Records, Office of the City Clerk, 200 S.
jZh—eim clvd. (714) 765-5166; thassaanaheim ; fax (714) 7654105.
STEPto receive an invoice for responsive records. The City shall determine within 1 0-days from receipt of a public
records request, whether the request, in whole or in popies of discloseable public records in possession of the
City [GC Q53(c)]. Please note that if you are requesting the opportunity to inspect records, you will be requested to make
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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Full Name: —&—s
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—I—) Ll !2_q Date:
Company Name:
(Mailing) Address. City/State/Zip Code: C,�—�2( �qq
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
do nts requested etc)
A
X
I understand that I will be contacted once documents have been identified. If production.of records is requested, an
estkwatef otst vMl tt xie sa—L I a;Wee t1.Ye r-allme-jE ttAzdta, l 1 f1r1u7lic?,ti,-v)x oists (aTtl
rmailing) prior to the production of the requested documents.
jyl wish to inspect City records El Will Pick -Up Records El Please Mail
Please note that information contained in any PRA request is a publif record and may be subject to public inspection pursuant to the
CA Public Records Act. �, ,
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il—GNATUiFE OF REQUESTER
(Government Code Section 6250 at seq.)
2, If your request is to inspect rather than receive copies, the responsive Departmentmill 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 Public Records Act.
3. Requcsts (irispection and copies) must be for records in the possessions of, prepared, owned, used,
or retained by the City of Anaheim [Gov. Code §6252(e)] and must be for clearly identifiable records.
City staff is available to assist you in identif}ing 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 "Viu not be
provided if disclosure is exempt in accordance with State Law.
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 fardier information, please refer to the Califomia Public Records Act (California Government
Code §6250 et seq.) or contact the Office of the City Clerk, 200 S. Anabeim Blvd., Suite 217,
Anaheim, CA 92805; Phone. (714) 765-5166.