This document is a form for documenting open records requests. It collects information about the requester including their name, address, contact details. It documents the date the request was received, how it was delivered, and who is responding. It asks for details on the type of records requested, any exempt records, and dates for informing the requester of availability and providing records. It also collects statistics on the number of documents/pages provided, copies, staff hours to respond, and any issues fulfilling the request.

1. Open Records Act – Documentation of Request
1. Requester’s Name:
Address:
Telephone No#
Fax No#
E-Mail Address:
2. Date request received:
3. Request delivered by:
Mail Fax
E-Mail Phone
Visit Other
4. Person responding to request
Division/Office
5. Type of records requested:
6. Describe any records exempt from ORA:
7. Date requester informed of availability/nonavailability of records:
8. Date records made available:
9. Number of documents (approx. number of pages) made available:
10. Number of copies provided:
11. Man hours required to respond to request:
12. Problems responding to request:
13. Comments:
CPS_36 Open Records Act- Documentation of Request Page 1 of 1
(Rev. 09/06)