Record Request

This is a request for records under the Missouri Sunshine Law, Chapter 610, Revised Statutes of Missouri. (MEDICAL and/or FIRE records are a different form)

I request that you make available to me the following records:

(Describe the records as specifically as possible. Where you are asking for records that cover only a particular period, such as last year or a specific month, identify that time period)

• If you know the subject matter of the records, but do not have additional information, use this alternative: I request that you make available to me all records that relate to

(Be as specific as possible; include dates if you can)

If you believe your request serves the public interest, and is not just for personal or commercial interest, you may ask that the fees be waived: I request that all fees for locating and copying the records be waived. The information I obtain through this request will be used to

(Tell how you will use the information and why that use is in the public interest)

Please let me know in advance of any search or copying if the fees will exceed $

(Insert amount you are willing to pay without additional information about the documents)

The custodian shall charge .10 cents per page for duplication costs and $35 dollars per hour for document search. The custodian shall receive (or may require) payment prior to duplicating documents. (Resolution 21-0916)

If portions of the requested records are closed, please segregate the closed portions, and provide me with the rest of the records.

If you want and are willing to pay for copies of the records, rather than just being able to see them:

I request that the records be copied and sent to me by

MAIL

PICKUP

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone

Date