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Public Records Request Form

  1. Please indicate document names, page numbers, addresses, and/or permit numbers where applicable.
  2. Commercial Purpose
    A "commercial purpose" is defined by A.R.S. Section 39-121.03 as the use of public records for:
    • Sale or resale, or to produce a document containing all or part of the record (such as a copy, printout, or photograph) for sale, or
    • Obtaining names and addresses from such public records for solicitation, or
    • For a purpose in which the purchaser can reasonably anticipate monetary gain from the direct or indirect use of such public record.
  3. Pursuant to A.R.S. Section 39-121.03, the applicant certifies that said documents:*
    Select one.
  4. For example, phone numbers, addresses, etc.
  5. This information will be used for:
  6. Include the market, client, or customer you intend to sell to, and the estimated price or value of the requested information.
  7. How would you like to receive your records?*
  8. I agree to pay the Required Fees and Deposits, if any, for the requested information.*
  9. Required if you wish to receive documents electronically.
  10. Electronic Signature Agreement*
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  11. Leave This Blank:

  12. This field is not part of the form submission.