Public Records Reproduction View Request Form. This is a Arizona form and can be use in Liquor Licenses And Control Statewide.
Tags: Public Records Reproduction View Request, LIC0109, Arizona Statewide, Liquor Licenses And Control
ARIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL 400 W Congress #521 Tucson AZ 85701-1352 (520) 628-6595 800 W Washington 5th Floor Phoenix AZ 85007-2934 (602) 542-5141 PUBLIC RECORDS REPRODUCTION/VIEW REQUEST Pursuant to A.R.S. Title 39-121.03 DO NOT WRITE IN THIS AREA – DEPT. USE ONLY NON-COMMERCIAL (Prices are subject to change) No. of Copies Photocopies @ $ per page $ 1 - 10 11 – 25 Board Section: Cassette Reproduction $10.00 per cassette $ 26 - 50 51 – 75 Document Certification: $2.00 per document $ 76 –100 100+ LICENSE # Cost No Charge $.10 per page .20 per page .30 per page .40 per page .50 per page COMMERCIAL* (Prices are subject to change) Photocopies @ $ per page Document Certification: $2.00 per document LICENSE # Total: $ $ $ COMPLETE THIS SECTION 1. Please check the appropriate box: Copy Request View Only – No Copies 2. Date: 3. Name of requesting party: 4. Liquor License #: 5. Licensee/Agent Name: Last First Middle 6. Corporation Name: 7. Business Name: 8. Documents Requested: 9. Certified for court use? YES NO 10. Do you directly or indirectly intend to: YES YES YES YES YES a) Sell or resell the documents? b) Sell or resell any of the information contained in the documents? c) Use any of the information contained in the public documents to produce a document for sale? d) Use any of the names or other information from the public documents for the purpose of solicitation? e) Do you anticipate to receive monetary gain from either the direct or indirect use of the public documents? NO NO NO NO NO *A.R.S. §39-121.03(D) For the purpose of this section, "commercial purpose" means the use of a public record for the purpose of sale or resale or for the purpose of producing a document containing all or part of the copy, printout or photograph for sale or the obtaining of names and addresses from public records for the purpose of solicitation or the sale of names and addresses to another for the purpose of solicitation or for any purpose in which the purchaser can reasonably anticipate the receipt of monetary gain from the direct or indirect use of the public record. Commercial purpose does not mean the use of a public record as evidence or as research for evidence in an action in any judicial or quasi-judicial body. lic0109 05/2005 Disabled individuals requiring special accommodations, please call the Department American LegalNet, Inc. www.FormsWorkflow.com