Public Records Request

Public Records Act found in Alaska Statute AS 40.25.100 – AS 40.25.220; and Alaska Administrative Code 2 AAC 96.100 – 2 AAC 96.900

Part 1 - Requester Contact Information

First Name:

Last Name:

Contact Phone:

Email Address:

Organization/Company:

Street 1:

Street 2 (optional):

City:

State:

Zipcode:

Preferred Communication Method:

Standard Mail E-Mail

Part 2 - Request Details

Under the Alaska Public Records Act, I am requesting an opportunity to inspect or obtain copies of the following public records (please provide details):

Request Details:

Date Range From:

Date Range To:

Please Note: If the information requested is unclear or if a large amount of information is requested you may be contacted to discuss clarifying or narrowing your request. There may be charges associated with production of the requested information. Should your public records request incur a charge, you will be contacted prior to the request being processed.

Part 3 - Certificate of Non-Litigation Affiliation (AS 40.25.122, 2 AAC 96.220)

By submission of this request, I certify that

I am not involved in litigation, in a judicial or administrative forum, with either the State of Alaska or a public agency to which the requested record is relevant; and I am not acting on behalf of or otherwise representing any person who is involved in litigation with the State of Alaska to which the requested record is relevant