Public Records Act Request Form

General Information January 28, 2014

This form should be used to request California public records that are made available pursuant to the California Public Records Act (Government Code Section 6250). Regional San prefers that requests be submitted electronically using this form; however, requests may be submitted by letter or email (see “How to Request Regional San Records“). If an alternate method is used, the information requested on this form should be included in the request.

Within 10 days of receipt of your request, a representative will contact you confirming its receipt and will indicate an approximate timeframe for response.

Information Request Detail

Range of Records Requested From:

To:

Type of Record(s) Requested: *

Please be as specific as possible.

Requesting Party Information

Full Name: *

Representing (if applicable):

Phone Number:

Alternate Phone Number:

Mailing Address: *

Email Address: *

Attachments?:

If you need to attach any files, do so here. PDF is preferred.

Referring Pages

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