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OPEN PUBLIC Request for Public Records

Steps

  1. 1. Step One
  2. 2. Step Two
  3. 3. Step Three
  4. 4. Step Four
  • Step One

    1. Open Public Records Request Form

    2. TOWNSHIP OF BLOOMFIELD, NEW JERSEY

    3. 1 Municipal Plaza, Room 214, Bloomfield, New Jersey 07003 Telephone (973) 680-4014–Facsimile (973) 680-0048.

    4. Township of Bloomfield New Jersey

    5. Important Notice:

      The last page of this form contains important information related to your rights concerning government records. Please read it carefully.

    6. REQUESTOR INFORMATION:

    7. Preferred Delivery*

    8. Is this a commercial request?*

    9. Payment Information

      Select Payment Method

    10. Fees

      Letter size pages -$0.05 per page, Legal size pages - $0.07 per page, Other materials (CD, DVD, ect) - actual cost of material.
      DELIVERY: Delivery / postage fees additional depending upon delivery type. EXTRAS: Special service charge dependent upon request.

    11. If you are requesting records containing personal information, please circle one: Under penalty of N.J.S.A 2C:28-3,

    12. I Ceritify That I:*

      Been convicted of any indictable offense under the laws of New Jersey, any other state, or the United States.

    13. Please be as specific as possible in describing the records being requested. Also, please not that your preferred method of delivery will only be accommodated if the custodian has the technological means and the integrity of the records will not be jeopardized by such method of delivery.

    14. Department*

    15. The Township will respond to you within seven (7) business days.

    16. Do you agree?*

      By clicking ?I agree,? you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your ?electronic signature? is valid and binding upon you to the same force and effect as a handwritten signature.

    17. Agency Use Only

    18. Custodian: If any part of request cannot be delivered in seven business days, details reasons here:

    19. Tracking#, Rec'd Date, Ready Date, Total Pages

    20. Total, Deposit, Balance Due, Balance Paid