Request Pursuant To Kansas Open Records Act Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Request Pursuant To Kansas Open Records Act Form. This is a Kansas form and can be use in 10th Judicial District (Johnson County) Local District Court.
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Tags: Request Pursuant To Kansas Open Records Act, Kansas Local District Court, 10th Judicial District (Johnson County)
REQUEST PURSUANT TO KANSAS OPEN RECORDS ACT
READ CAREFULLY BEFORE SIGNING
“No person shall knowingly sell, give or receive, for the purpose of selling or
offering for sale any property or service to persons listed therein, any list of names
and addresses contained in or derived from public records...” K.S.A. 45-230(a).
Violation of this law may subject the violator to a civil penalty of $500.00 for each violation.
By signing below, I acknowledge that I am aware of and understand K.S.A. 45-230. Pursuant to the
Kansas Open Records Act, I request the following records (Please specify):
Requester Name:____________________________________________
(Please Print)
Address:____________________________________________________Phone:_______________
Requester Signature:_____________________________________ Date Submitted:___________
By signing this request form, the requester makes the following certification pursuant to
K.S.A. 45-220(c)(2): “the requester does not intend to, and will not: (A) Use any list of names or
addresses contained in or derived from the records or information for the purpose of selling or
offering for sale any property or service to any person listed or to any person who resides at any
address listed; or (B) sell, give or otherwise make available to any person any list of names or
addresses contained in or derived from the records or information the purpose of allowing that
person to sell or offer for sale any property or service to any person listed or to any person who
resides at any address listed.”
FOR OFFICE USE ONLY:
Form of Identification ____________________________________________________
Request: [ ] Granted [ ] Denied [ ] Delayed
Fees Charged:
________________ Copies
________________ Staff Time
________________ Computer Service
________________ Total
SIGNATURE _________________________________ Date____________________________
Director, Department of Records & Tax Administration
American LegalNet, Inc.
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