Open Records Request

Pursuant to O.C.G.A. § 50-18-71, I understand that records provided are based on the available format. I agree to pay any copying and/or administrative costs incurred in fulfilling my request to the extent permitted by Georgia law. Such costs may include copying charges of $.10 cents per page, administrative charges for search, retrieval, redaction, and other direct administrative costs; O.C.G.A. § 50-18-71(c). There is no charge for the first fifteen (15) minutes, and the hourly charge shall not exceed the salary of the lowest paid employee who has the necessary skills and training to carry out the request. I also have the right to receive an estimate of the cost prior to purchasing any information. Specifically, any documents that contain personal information such as social security numbers, insurance and medical information (O.C.G.A. § 50-18-72(a) (2), are not subject to disclosure, The Law requires a response within three (3) business days upon receipt of a request. While it is the policy of the Clayton Center Community Service Board to comply with the Open Records Act to provide requested and available documents within three (3) business days of the request, it may be impossible due to volume and other factors. Explanation of such delays will be provided in writing.Please fill out the form below. Required fields are indicated with a * symbol. Thank you.

* Full Name
* Full Address
* Phone Number
FAX

I am making an Open Records Act Request to receive documents related to the individual and/or incident described below:

* Individual's Full Name
* Indicate Preferred Method of Delivery