Request for Disclosure of Documents Under the Open Records Act

REQUEST FOR DISCLOSURE OF DOCUMENTS UNDER THE OPEN RECORDS ACT
There may be a fee incurred to the extent permitted by Georgia law. If a fee amount is determined, someone will notify you before completing the request. These costs are for search, retrieval, and other administrative tasks such as these charges do not exceed the salary of the lowest paid full-time employee who has the necessary skill and training to perform the request. The requester is not charged for the first fifteen minutes of time. I agree to pay any copying and/or administrative costs that may be incurred in fulfilling my requests to the extent permitted by Georgia law.

Defendant Information
Defendant's Full Name*

First NameMiddle NameLast Name
Defendant's Date of Birth*

MonthDayYear
Date
Defendant's Social Security Number
Offense(s) Cited For
Date/Time of Offense*

MonthDayYear
Date
Hour MinutesAM/PM Option
Date/Time of Incident*

MonthDayYear
Date
Hour MinutesAM/PM Option
Date of Conviction

MonthDayYear
Date
Incident or Accident #
Location of Incident
Officer
Request Type:
Type of documentation being requested*

Copy of Citation(s)Copy of DUI Report(s)Copy of Disposition(s) of Case(s)Letter of Reinstatement for LicenseOther
Citation #(s)
Event Type
Pursuant to O.C.G.A. SS 50-18-70 et seq., I am formally requesting to inspect certain public records. In particular, records requested for inspection are:*
Additional Information
RECORD RETRIEVAL FEES

Actual time of record preparation including research (varies) (less 15 min.)	Hrs x $	=$
Actual time of copying (varies)	Hrs x $	=$
$0.10 per page copy (8 1/2 x 11) $0.20 per page copy (11 x 17) $2.00 per page for building plan	___ Pages @ $0.10 ___ Pages @ $0.20 ___ Pages @ $2.00	=$ =$ =$
Postage		=$
Other costs:		=$
Video costs:	Copies @ $:	=$
Total actual costs:		=$