Public Records Request (Commercial) Form - City Of Dayton, Kentucky printable pdf download

PUBLIC RECORDS REQUEST (COMMERCIAL)

Name:

_______________________________

Address:

_______________________________

City, State and Zip

_______________________________

Daytime Phone:___________

Evening Phone:___________

Records Requested: (add additional pages if necessary): Receive by Mail

Office

Receive in

Form of Record Requested(if available): Hard Copy

UNIX/WordPerfect

ASCII

"COMMERCIAL PURPOSE" is defined by law as the direct or indirect use of any public record or records, in any form, for sale,

resale, solicitation, rent, or lease of a service, or any use by which the user expects a profit either through commission, salary or fee. It

shall not include publication or related use of a public record by a newspaper or periodical; sue of a public record by a radio or

television station in its news or other informational programs; or use of a public record in the preparation for prosecution of defense

of litigation or claims settlement by the parties to such action or the attorneys representing the parties.

Please State Commercial Purpose: ____________________________________________________________

_______________________________________________________________________________________

I agree to enter into a contract with the City of Dayton, Kentucky to pay a fee for the above records, that fee to be based upon the cost

to the City of Dayton of medial, mechanical processing and staff required to produce a copy of the above records or the cost to the

City of the creation, purchase or acquisition of the public records or both. I understand that it is unlawful to use public records for a

commercial purpose unless certified herein or for a commercial purpose other than that stated. Further, I understand that the city may

collect damages of 3 times the amount that would have been charged if the actual commercial purpose had been stated. along with

costs of collection of damages including reasonable attorneys fees and may impose any other penalty established by law.

I certify that the above statements are true to the best of my knowledge.

Date:________

______________________________

Signature

Subscribed, sworn and acknowledged this _____ day of ______________, 19__

__________________________________

My commission expires:

Notary Public

Public Records Request (Commercial) Form - City Of Dayton, Kentucky