Public Records Request Form

First Name(Required)

Last Name(Required)

Company (if applicable)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

Preferred method of contact in the event of a question(Required)

Records Requested(Required)

Time period covering documents requested(Required)

Format request

I wish to inspect the requested records, where applicable, and do not want copies produced at this time.

I would like electronic copies of the records sent to me by email (some files may be too large to email).

I would like paper copies, CDs, or DVDs, of the requested records.

Signature(Required)

Inspection of Records

Please note that if you are requesting to review records in person at the Calleguas headquarters, Calleguas staff will need to be present during any review. You will be required to make an appointment to review the documents at the Calleguas office.

Payment for Production of Records

For paper records, you will be charged the direct cost of duplication at a rate of $0.05 per page. The same charge applies whether the paper copies are generated from paper documents, computer database programs, electronic media, microfiche, or similar. There will be no charge if the total cost to produce requested paper records is less than $50 within a one-year period.

For electronic records, you will bear the cost of producing a copy of the record, including the cost to construct the record and the cost of programming and computer services necessary to produce a copy of the record when either of the following applies: (1) the record is one that is produced only at otherwise regularly scheduled intervals or (2) data compilation, extraction, or programming would be required to produce the record. The cost to construct the records on a CD or DVD is $4.00 each. There will be no charge if the total cost to produce and construct requested electronic records is less than $50 within a one-year period.

Calleguas will provide written notice of charges due. Paper and/or electronic records will not be produced until payment has been received and funds are posted to Calleguas’s account.