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2. Date*
   Date
   Enter today's date
4. Under the Open Records Request KRS 61.0870 (2), I am requesting to review or copy:
6. Description of records being requested:*
8. Please certify below whether your intended use for the requested material is commercial or non-commercial. If the use is non-commercial, we need no further information. If the use is commercial, we will determine the appropriate charge for that material based upon KRS 61.874 (4).
   "Commercial purpose" means the direct or indirect use of any part of a public record or records, in any form, for sale, resale, solicitation, rent, or lease of a service, or any use by which the user expects a profit either through commission, salary, or fee. "Commercial purpose" shall not include: 1. Publication or related use of a public record by a newspaper or periodical; 2. Use of a public record by a radio or television station in its news or other informational programs; or 3. Use of a public record in the preparation for prosecution or defense of litigation, or claims settlement by the parties to such action, or the attorneys representing the parties;
10. Use of records:*

    1. Commercial Purpose
    2. Non-Commercial Purpose
12. If commercial purpose:
14. Company Name
15. Telephone Number*
17. Mailing Address

    (Provide only if requesting records to be mailed)

19. Statement regarding residency. I further state that I am a resident of Kentucky because I am (please check one):*

    1. An individual residing in the Commonwealth; or
    2. A domestic business entity with a location in the Commonwealth; or
    3. A foreign business entity registered with the Kentucky Secretary of State; or
    4. An individual that is employed and works at a location within the Commonwealth; or
    5. An individual or business entity that owns real property within the Commonwealth; or
    6. An individual or business entity that has been authorized to act on behalf of an individual or business entity listed above; or
    7. A news-gathering organization as defined in KRS 189.635(8)(b)1a. to e.
21. I understand the City has five (5) working days to respond to my request. Please refer to the fee schedule for copying/processing costs. In the event the City refuses my request, I understand that the refusal will state the justification for the refusal and will be provided to me at the time a response is due.
23. First Name*
25. Last Name*
27. Signature*

    By typing my name here, I am affixing my signature to this request.

29. Address1
31. Address2
33. City
34. State
35. Zip
37. Email*
39. Preferred method of obtaining records*

    1. First class mail (postage and copying charges apply)
    2. Email (scanned or electronically reproduced)
    3. In-person inspection
Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field