Request Process:

1. Fill out and submit form

2. Receive confirmation email (if provided)

3. Receive call or email when completed or for clarification

Asterisk (*) marks required fields.

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Requestor

Name

 *

Name

Address

 *

Address

Address

Address

City, State, ZIP Code

 *

City, State, ZIP Code

Phone

 *

Phone

Email Address

Email Address

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Records(s) Requested:

Please provide a detailed description of the records requested. Make sure your request is a specific as possible, so that your request may be filled quickly and completely.

Record Title

 *

Record Title

Description

 *

Description

Record Date or Date Range

Record Date or Date Range

Department

Department

Number of Copies

 *

Number of Copies

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Charges:

A charge for providing copies of public records has been set by the Governing Body. The fee schedule established by the City is available online. 

 

Advisory:

A list of names and addresses shall not be obtained from public records for the purpose of selling or offering for sale any property or service to the persons listed. This provision pertains to the names and addresses of businesses listed in the public records, as well as the individuals. K.S.A. 45-220(c) (2), K.S.A. 45-230.

Signature of Requestor:

I have made a written request for access to and/or copies of certain records identified above pursuant to the Kansas Open Records Act, and do hereby certify: 1) That I do not intend to and will not use any list of names or addresses contained in or derived from the records or information obtained from the City of Prairie Village for the purpose of selling or offering for sale any property or service to any person on the list or to any person who resides at any address on the list. 2) That I do not intend to and will not give, or otherwise make available, to any person any list of names or addresses contained in or derived from the records or information obtained from the City of Prairie Village for the purpose of allowing that person to sell or offer for sale any property or service to any person on the list or to any person who resides at any address on the list. 3) That I have been informed and am aware that to knowingly sell, give, or receive any list of names or addresses contained in or derived from public records for the purpose of selling or offering for sale any property or service to persons on the list is a violation of state statute (K.S.A. 45-230) and that any person violating the prohibition shall be liable for payment of a civil penalty.

 *

Signature of Requestor: I have made a written request for access to and/or copies of certain records identified above pursuant to the Kansas Open Records Act, and do hereby certify: 1) That I do not intend to and will not use any list of names or addresses contained in or derived from the records or information obtained from the City of Prairie Village for the purpose of selling or offering for sale any property or service to any person on the list or to any person who resides at any address on the list. 2) That I do not intend to and will not give, or otherwise make available, to any person any list of names or addresses contained in or derived from the records or information obtained from the City of Prairie Village for the purpose of allowing that person to sell or offer for sale any property or service to any person on the list or to any person who resides at any address on the list. 3) That I have been informed and am aware that to knowingly sell, give, or receive any list of names or addresses contained in or derived from public records for the purpose of selling or offering for sale any property or service to persons on the list is a violation of state statute (K.S.A. 45-230) and that any person violating the prohibition shall be liable for payment of a civil penalty.

Yes

No

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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