Public Records Request
SUSD public records request form under Arizona Public Records Law (§ 39.101 et seq.).
Date
*
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Month
-
Day
Year
Date
Requester Information
Name
*
First Name
Last Name
If applicable, name of agency, company, department, etc. requesting records
Address
*
Street Address
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Records Being Requested
I wish to obtain a copy of the record via:
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Electronic Copy
CD
Photocopy
Records Inspection (in-person)
Records Being Requested
*
Please specifically describe the record requested for review.
Use of Record
*
Commercial
Non-Commercial
Commercial Use
If you intend to use these documents for commercial purpose state the commercial purpose in the field above for which the above -requested public records will be used. (A.R.S. 39-121.03). Commercial fee is applicable.
Signature of Requesting Party
For non-commercial use records requests, please include your electronic signature below. (First name, Last name, and Date of Birth)
Requesting Party E-Signature: First and Last name and Date of Birth (MM//DD/YYYY)
*
Date of Signature MM/DD/YYYY
*
-
Month
-
Day
Year
Date
Electronic Signature Confirmation
*
I agree that by submitting this Claim Form I certify under the penalty of perjury of the laws of the United States of America that the foregoing is true and correct and that checking this box constitutes my electronic signature on the date of its submission, which has the same legal effect and meaning as a written signature.
Submit
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