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02282024-2EIM City of Anaheim Office of the Ci�jwrity Clerk 200 S. Anaheim Vvd., Suite 217 Anaheim, CA 92805 (714) 765-5166 - fax (714) 765-410S www.anah.eim.net R�9yWfP.R.-PUBLIC RECORDS 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. (714) 765-5166; thass@a �naheitn.net; fax (714) 7654105. STEP 3: WArr to receive an invoice for responsive records. The City shall determine within I 0-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 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 INFO TIN q Full Name : W&52O2 Company Name: (Mailing) Address: ity/State/Zip Code: � Y%he'l, "04 (A 112o 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) CA w�Ae- �etidc, Oly Inde, bvic lki V-4s per-iceel "fit 1 11e, Inc �CAk' W0r', n I 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. F] I wish to inspect City records [] Will Pick -Up Records Please Mail Please note that information contained in any PRA request public record and may be subject to public inspection pursuant to the CA Public Records Act. 4;= SIG ATURE OF REQUESTER INSTRUCTIONS FOR REQUESTING PUBLIC RECORDS (Government Code Section 6250 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., 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 and 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 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 Public Records Act. 3. Requests (inspection 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 identifying those records in the Department/City's possession. The City is not required by law to create a, record or Est 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 with 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 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 Copy charges are enumerated on the City Clerk's Fee Schedule as adopted by the City Council (RES- 2018-075), 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 are $10.00 per CD. 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 §6250 et seq.) or contact the Office of the City Clerk, 200 S. Anaheim Blvd., Suite 217, Anaheim, CA 92805; Phone: (714) 765-5166.