Commercial Public Records Request Form

I,(Required)

am the(Required)

of(Required)

whose address is:(Required)

Street Address Address Line 2 City State ZIP Code

which is engaged in the business of(Required)

The public records being requested are for the following commercial purpose(s):(Required)

I/we wish to(Required)

inspect or(Required)

receive copies of the following records:(Required)

Certify that all the information provided is true and correct under penalty of perjury.
Declare that I have read the information and instructions pamphlet accompanying this form and understand its contents.
Declcare that the copies or reproductions will not be used directly or indirectly for any purpose other than that described nor will the copies or reproductions be transmitted or resold to any other person or entity without specific authorization of the County Attorney's records custodian.
Agree to delete all data acquired as a result of this request from my and the entity's databases and all other electronic media forms upon completion of the purpose or use for which this request is made.
Agree not to hold Pima County and the Pima County Attorney's Office liable for any inaccurate or incomplete information received.
Agree, prior to obtaining copies of the documents requested, to pay the fee assessed which will be based on the following:

The actual hourly rate, including benefits, for staff and attorney time spent in locating the materials requested.
The actual hourly rate, including benefits, for all staff and attorney time spent in reviewing, redacting and copying the materials, plus overhead to defray the costs of the software, equipment, and supplies necessary for the reproduction.
$25.00 per CD containing information, $.035 per page for paper copies and the actual cost of the medium and the reproduction, for information in any other reproduction format

Requesting Party's Signature:(Required)

Date(Required)

Phone Number(s):(Required)

Email Address or Fax Number:(Required)

Requesting Party's Address:(Required)

Street Address Address Line 2 City State ZIP Code

Please mail the requested public records to the address above.

Please e-mail or fax the requested public records to the email address / number above. (NOTE: Requests exceeding 20 pages cannot be faxed.)

info@pcao.pima.gov