Free Request for Record Inspection or for a Copy - Kansas


File Size: 9.5 kB
Pages: 4
Date: February 12, 2007
File Format: PDF
State: Kansas
Category: Court Forms - State
Author: Unknown
Word Count: 573 Words, 5,530 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.kscourts.org/dstcts/4frmrfr.pdf

Download Request for Record Inspection or for a Copy ( 9.5 kB)


Preview Request for Record Inspection or for a Copy
REQUEST FOR RECORD INSPECTION OR FOR A COPY (The section below is to be completed by person making the request) Date: Name: Address:

Daytime Phone: Fax: ___________________________________ I certify that I do not intend to, and will not: (1) Use any list of names or addresses contained in or derived from the records or information requested for the purpose of selling or offering for sale any property or service to any person listed or to any person who resides at any address listed; or (2) sell, give, or otherwise make available to any person any list of names or addresses contained in or derived from the records or information for the purpose of allowing that person to sell or offer for sale any property or service to any person listed or to any person who resides at any address listed. See K.S.A. 45-230. Signature: __________________________________________________________________ RECORD SOUGHT: Please provide as specific a description as possible of the records you desire to inspect or for which you request a copy. Include records titles and dates as well as the name of the court which holds the record. Description of Record 1. 2. 3. # of copies desired

________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________

CHARGES: A charge for providing access to public records is authorized by state law and has been established by the Kansas Supreme Court. Charges are set to compensate for the actual costs in honoring your request. The fee schedule established for this Judicial District is posted in the office of the Clerk of the District Court. The charge for access to and/or copies of the record(s) you have requested is estimated to be $ ___________________. Prepayment of the above amount may be required.

(The section below is to be completed by the Record Custodian) Time of request: ________________________________________________________________ (Date) (Time) (Person receiving request) Records Provided or Denied: ______________________________________________________ (Date) (Time) (Person providing record or denial) Staff time involved: ___ hours, ___ minutes, for a charge of $ _________________________. Charge for copies made: $ ___________________ Total Charges: $ ___________________ Estimated payment received $ ___________________ Amount remaining due $ ___________________ (or) Amount refunded $ ___________________

______________________________________ Record Custodian

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RECORD REQUEST OR COPY DELAY NOTICE TO: Name: ____________________________________________________________________ Address:___________________________________________________________________ __________________________________________________________________________ Daytime Phone: _________________________________ Fax: ___________________________________ Your request dated _______________, 20___, for inspection or copies of the following records has been delayed: 1. __________________________________________________________________________ 2. __________________________________________________________________________ 3. __________________________________________________________________________ (Title or description of record) The reason for the delay is: ____ Additional information is required to identify the record you have requested. Please provide more detailed information here:________________________________________ ________________________________________________________________________ ________________________________________________________________________ Our search for the record is continuing and you will be contacted when it is located. The record requested has been checked out from this office. It is scheduled to be returned and will be made available to you on or before ___________________________, 20___, at _________________ o'clock. This office is attempting to establish whether the record requested is an open public record. __________________________________ Record Custodian __________________________________ Date Time

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RECORD REQUEST OR COPY DENIAL NOTICE TO: Name: ____________________________________________________________________ Address:___________________________________________________________________ __________________________________________________________________________ Daytime Phone: _________________________________ Fax: ___________________________________ Your request dated _______________, 20___, for inspection or copies of the following records has been denied: 1. __________________________________________________________________________ 2. __________________________________________________________________________ 3. __________________________________________________________________________ (Title or description of record) The reason for the denial is: ____ ____ The record requested is not made, maintained, kept by, or in the possession of this office. The record requested is not required to be disclosed under the Kansas Open Records Act, pursuant to ________________________ (cite section of Act). Access to the record requested is restricted under federal or state law, pursuant to ______________________________ (cite law relied upon).

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It is your right to challenge this denial, if you so choose, by means of a legal action.

__________________________________ Record Custodian __________________________________ Date Time

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