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Public Record Access Request

2. State Law Compliance
   Note: All requests for access to public records may be referred to the City Attorney to ensure compliance with state law.

   Note: All requests for access to public records may be referred to the City Attorney to ensure compliance with state law.

4. Request Time
   The City reserves a minimum of three business days (24 working hours) in which to comply with this request, in order to allow sufficient time for retrieval, printing, copying and/or arrangements for inspection, as applicable, and assessment of applicable charges, without disrupting the essential functions of City staff.

   The City reserves a minimum of three business days (24 working hours) in which to comply with this request, in order to allow sufficient time for retrieval, printing, copying and/or arrangements for inspection, as applicable, and assessment of applicable charges, without disrupting the essential functions of City staff.

6. Cost
   Costs for copies are $0.25 per page for 8 ½” x 14” or smaller, or $1.00 per page for certified copies. Requests for copy or inspection of public records that require more than one hour of staff time for retrieval, compilation and/or monitoring of the inspection process may result in the imposition of a search fee equivalent to $15 per hour.

   Costs for copies are $0.25 per page for 8 ½” x 14” or smaller, or $1.00 per page for certified copies. Requests for copy or inspection of public records that require more than one hour of staff time for retrieval, compilation and/or monitoring of the inspection process may result in the imposition of a search fee equivalent to $15 per hour.

8. Name of City Department in Possession of Requested Records

   If Known

9. Date of Request
   Date of Request

11. Name

12. Phone Number

14. This request is for:

    Please check all that apply.

    1. Copying

    1. Inspection
18. Record Description

    Title/Date/Other Identifying Information

20. Number of Pages

    If Known

21. Number of Copies

25. Record Description

    Title/Date/Other Identifying Information

27. Number of Pages

    If Known

28. Number of Copies

32. Record Description

    Title/Date/Other Identifying Information

34. Number of Pages

    If Known

35. Number of Copies

39. Copies Only
    Please note that, in cases where only copies of records are available, inspection will be waived and you will be charged the appropriate copying charges only.

    Please note that, in cases where only copies of records are available, inspection will be waived and you will be charged the appropriate copying charges only.

41. Copies Need to be Certified as True and Correct

    1. Yes

    1. No

43. This request is made for:

    1. Business/Commercial Purposes

    1. Personal Use

45. I have been advised that a charge for copying public records is, and a reasonable fee to recover the direct cost of record search may be, authorized by State law and have been established by the City of Glenpool, as applicable.

    1. I Agree

47. Title or Business Identity

    If Applicable

49. Request Date and Time
    Request Date and Time

    Request Date and Time

50. Produced Date and Time
    Produced Date and Time

    Produced Date and Time

    Time stamp and return a copy to requesting party with response.

52. Delay in Production

    1. Yes

    1. No

53. Reason for Delay

    If Any

55. Number of Copies Made

56. Copy Charge at $0.25 Per Copy

57. Certified Copy Charge at $1.00 Per Copy

59. Inspection of Records

    Hours and Minutes

60. Search Charge

    If Any, at $15.00 Per Full Hour Plus ¼ Hour Increments at $3.75 Beyond First Hour

61. Staff Time Charge

    If Any, at $15.00 Per Full Hour Plus ¼ Hour Increments at $3.75 Beyond First Hour

63. Total Actual Charges

65. Deposit Paid

    For Estimated Charges

67. Charges (or Refund) Owed

69. Total Paid

70. Receipt Number

72. Record Not Produced

73. Reason Record Was Not Produced

75. Record Not Produced

76. Reason Record Was Not Produced

78. Record Not Produced

79. Reason Record Was Not Produced

81. Signature of Record Custodian

82. File ID

Leave This Blank:


84. 1. Receive an email copy of this form.
85. Email address

    This field is not part of the form submission.

86. Submit

* indicates a required field