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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.
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.
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.
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. Email Address
15. This request is for:

    Please check all that apply.

    1. Copying

    1. Inspection
19. Record Description
    Title/Date/Other Identifying Information
21. Number of Pages
    If Known
22. Number of Copies
26. Record Description
    Title/Date/Other Identifying Information
28. Number of Pages
    If Known
29. Number of Copies
33. Record Description
    Title/Date/Other Identifying Information
35. Number of Pages
    If Known
36. Number of Copies
40. 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.
42. Copies Need to be Certified as True and Correct

    1. Yes

    1. No
44. This request is made for:

    1. Business/Commercial Purposes

    1. Personal Use
46. 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
48. Title or Business Identity
    If Applicable
50. Request Date and Time
    Request Date and Time

    Request Date and Time
51. Produced Date and Time
    Produced Date and Time

    Produced Date and Time
    Time stamp and return a copy to requesting party with response.
53. Delay in Production

    1. Yes

    1. No
54. Reason for Delay
    If Any
56. Number of Copies Made
57. Copy Charge at $0.25 Per Copy
58. Certified Copy Charge at $1.00 Per Copy
60. Inspection of Records
    Hours and Minutes
61. Search Charge
    If Any, at $15.00 Per Full Hour Plus ¼ Hour Increments at $3.75 Beyond First Hour
62. Staff Time Charge
    If Any, at $15.00 Per Full Hour Plus ¼ Hour Increments at $3.75 Beyond First Hour
64. Total Actual Charges
66. Deposit Paid
    For Estimated Charges
68. Charges (or Refund) Owed
70. Total Paid
71. Receipt Number
73. Record Not Produced
74. Reason Record Was Not Produced
76. Record Not Produced
77. Reason Record Was Not Produced
79. Record Not Produced
80. Reason Record Was Not Produced
82. Signature of Record Custodian
83. File ID
Leave This Blank:


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

    This field is not part of the form submission.

87. Submit

* indicates a required field