1. Home
  2. 3000s
  3. 3570(Y) Public Access to Government Records, Form

3570(Y) Public Access to Government Records, Form




Directions: In order to provide you with the requested information, please complete this form and be advised that the following conditions apply:

  1. Requests for access to public records must be in writing and either hand delivered, mailed, or transmitted electronically to the records custodian.
  2. All records covered under the Right-to-Know legislation will be available during regular business hours and will be available within seven (7) business days.
  3. If any requested document is not a public record, a response will be provided within seven (7) business days. Where the legal determination must be made as to whether records are “public records” as provided by law, the request will be reviewed by the district’s solicitor.

The legislation sets that OPRA fee schedule in the following ways:

  1. Every public agency must charge $0.05 per page for letter sized pages and smaller.
  2. Every public agency must charge $0/07 per page for legal sized pages and larger.
  3. Any public agency whose actual costs to produce paper copies exceed the $0.05 and $0.07 rates may charge the actual cost of duplication. (Note: the actual cost calculation is included on page 2 of this issue).
  4. Every public agency must provide electronic records FREE OF CHARGE (i.e. records sent via e-mail or fax).
  5. Every public agency must charge the actual cost to provide records in another medium (i.e. computer disc, CD-ROM, DVD)
  1. Prepayment is required for the duplication of documents/records. There is no fee involved in simply inspecting a document/record.
  2. If a request is made for a copy in a format other than photocopy, reasonable efforts will be made to provide the information in the format requested. The cost will be based on the costs of producing the format requested. The requestor will be informed of any special fees before any copying project is undertaken and prepayment is required.
  3. Anonymous requests for access to government records are permitted. However, if indentifying information is not included on the form, there can be no response until the person reappears in the office.
  4. The requestor has the right to challenge a decision denying access to a public record. Two options are provided:

Name: (Please Print)


Telephone (Day): Preferred Delivery: Pick Up US Mail On Site Inspection Record(s) Requested:

For Office Use Only

Date of Response:


Total Number of Page:

Total Fee Paid: $

Records Released: Checked (√) items noted above.

Requestor’s record(s) not Released and Reason:

Requested Records Have Been Provided

Requestor’s Signature:


Authorized Staff Member’s Signature:


Was this article helpful to you? No Yes

How can we help?