TOWNSHIP OF FAIRFIELD

public records request forms.pdf

TOWNSHIP OF FAIRFIELD

230 Fairfield Road

Fairfield, New Jersey 07004

(973) 882-2701

REQUEST FOR PUBLIC RECORDS

Name: ______________________________________________________________

Address: ______________________________________________________________

______________________________________________________________

Telephone (Day) ______________________________________________________________

Information Requested:

(____) Copy of Minutes (specify board or entity, date, topic or other identifying information)

__________________________________________________________________________

(____) Copy of Ordinances or Resolution (specify date, number or other identifying information)

__________________________________________________________________________

(___) Police Accident Report Fee __________________

Date and Location of Accident ________________________________________________

Other (specify) _________________________________________________________

__________________________________________________________________________

(___) License Information (specify) _________________________________________________

__________________________________________________________________________

_____________________________________________________________

(___) Other Departments _________________________________________________________

__________________________________________________________________________

Information on a Specific Property Address ___________________________________________________________

Block _______________ Lot _________________________

(___) Municipal Lien Search Fee ________________

Municipal Lien Searches are provided by the designated search officer and will be provided

within 15 days after the request if received and the fee paid, as provided in N.J.S.A. 54.5-11,

et seq

(___) List of Property Owners within 200’ Fee ________________

As provided in N.J.S.A. 40:55D-12, the fee is the greater of $.25 per name or $10.00

_________________________________________________________________________________________________

**For Municipal Use Only**

The information requested will be ready on ____________________________________

Estimated Number of Pages ___________________ Estimated Cost _______________________________

Deposit ___________________________

(required where the anticipated cost of reproduction exceeds $5.00)

TOWNSHIP OF FAIRFIELD

PUBLIC RECORDS REQUEST RESPONSE

TO: _____________________________________________________________

DATE: _____________________________________________________________

For the following reason(s), the document(s) listed below and requested by you are not being provided

Because the document(s) are not public records as provided by law:

_________________________________________________________________________________

__________________________________________________________________________________________________

You have a right to appeal the decision that the document(s) are not public records. You may take your

appeal to the Government Records Council or to the New Jersey Superior Court, as provided by N.J.S.A.

47:1A-1 et seq. If your request has been denied, a statement of the procedures for the appeal will be

attached to this notification.

ACKNOWLEDGMENT

I hereby acknowledge that the documents specifically listed above will not be provided. I further

acknowledge that I have received information on the procedures for any appeals of the determination.

_________________________ _____________________________________

Date Applicant

_________________________ _____________________________________

Date Municipal Clerk

A request for a copy of Public Records should be submitted on this form, which has been adopted by the Custodian of Records for

Requests related to Police Department Records, Some records will be immediately available during normal business hours Some records will require time to locate and to make the copies requested, but will normally be available during normal business hours and within seven (7) business days. If any document or copy which has been requested is not a public record or cannot be provided within the seven (7) business days, you will be provided with a response with that information within the seven (7) business days. Some records requested have specific fees or other response times established by statue. There is no fee involved in simply inspecting a document during normal business hours. The request may be filed electronically. In general:

· Except as otherwise provided by law or regulation, the fee assessed for the duplication of a printed record shall be: first page to tenth page, $0.75 per page; eleventh page to twentieth page, $0.50 per page; all pages over twenty, $0.25 per page; for a police accident report there is an additional fee when the request is not made in person of $5.00 for the first 3 pages and $1.00 for each additional page, as provided by N.J.S.A. 39:4-131.

· Where a request is for a copy in a format other than a 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.

· Where a legal determination must be made as to whether records are “public records” as provided

by law, the request will be reviewed by the Municipal Attorney.

The term “public records” generally includes those records determined to be public in accordance with N.J.S.A. 47:1A-1. The term does not include employee personnel files, police investigation records, or other matters in which there is a right of privacy or confidentiality or which is specifically exempted by law.

ACKNOWLEDGEMENT

The Applicant hereby acknowledges receipt of a copy of this form with the date on which the information is expected to be available and the estimated cost. The applicant hereby certifies that he or she has not been convicted of any indictable offense under the laws of this State, any other state or the United States and is not seeking government records containing personal information pertaining to the victim or the victim’s family as provided by N.J.S.A. 47:1A-1 et seq.

I hereby acknowledge that I have received the document(s) requested except for any document(s)

Specifically listed on the Public Records Request Response Form.

_____________________________ ____________________________

Applicant Custodian of Records

Date _________________________ Date: _______________________