Public Records Request Form

Public Records Request Form

Pursuant to the McKee Act of 2011
REQUEST FOR PUBLIC RECORDS

Associated Students Incorpotated at California State University, Sacramento (ASCSUS) encourages public participation in the governing process and provides reasonable accessibility to all public records, except those documents which are exempt from disclosure by express provisions of law or considered confidential or privileged under the law. ASCSUS, in accordance with Government Code Section 6256, has ten (10) days to respond to any request for public documents by indicating whether or not the documents exist and will be made available. Actual production of the documents may take somewhat longer, depending upon their ease of availability and staff workload. To assist us in providing a timely response to your request, please fill out the form below and indicate the specific record document you wish to review.

For more information about the McKee Act of 2011 click here.
Date of Request:*

MonthDayYear
Requester Information*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Email Address*
example@example.com
RECORD OR DOCUMENT REQUESTED

To assist with your request, please identify each requested record/document separately. Please be as specific as possible. Non specific inquiries may cause response to be delayed. Documents will be emailed to the email address listed above unless otherwise requested.
Description of Records Requested*
(Please be as specific as possible: include dates, names, subject matter, file types, etc.)
Preferred Format of Records (check one):

Paper CopiesElectronic CopiesInspection Only
Delivery Method (check one):

Pick Up in personEmailMail (address required above)
Acknowledgment of Fees

I may be charged the actual costs of duplication, extensive clerical or supervisory assistance, or other applicable fees as authorized.
Signature of Requester

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Government Office Use Only

Request Received by:_______________________________

Approved By: _______________________________

Date/Time Received: ________________________________

Released To: ______________________________

Comments: ______________________________________
Should be Empty:

Public Records Request Form

REQUEST FOR PUBLIC RECORDS

RECORD OR DOCUMENT REQUESTED

Acknowledgment of Fees

Government Office Use Only