Borough

Allendale,

of Allendale
NJ 07401'-

Municipal Building 500 West Crescent Avenue

REQUEST

FOR ACCESS TO GOVERNMENT RECORDS

FOR MUNICIPAL USE ONLY

Date Received: SEE Name: Address: INSTRUCTIONS ON

Date THE

of Response: OTHER SIDE

Telephone Information [__}

[Day] Requested: Copy of Minutes [specify board or entity, date, topic or other identifying information]

[__]

Copy

of Ordinance

or Resolution

[specify

date,

number,

or other

identifying

information]

[___]

Police

Accident Identify

Report

Fee:

Accident:

[__.]

Other

[specify]

[___]

License

Information

[Specify]

Information

on

a Specific

Property

Address Block Lot Fee:

[__]

Municipal

Lien

Search

__

$1o.o_o

Municipal Lien Searches are provided by the designated search officer and will be provided wittin days after the request is received and the fee paid, as provided inN.J.S.A. 54"5-1 I, et seq. [___] List of Property Owners inNJ.S.A. within 200' Fee: the fee is the greater of $.25 per name or $10.0(J Records the Custodian Some st_ohld of during records be submitted Records. will require normal time on this form

15

As provided A request has make been the immediately for access available copies to or for by the during

40:55D-12,

a copy normal

of Government Clerk business normally as hours.

'_,vhich will and be to

adopted

Municipal but will

Some business

records to compile hours and

requested, days. within the

be available

x-within

seven (7) business cannot be provided information within response times normal business

If any document or copy which has been requested the seven (7) business days, you will be provided (7) business days. Some records requested

is not a public with a response have specific fees a document

record or witlh that or other dluring

seven

established by statute. There is no fee involved hours. This request may be filed electronically.

in simply inspecting In general:

Immediate access is ordinarily available for to budgets, bills, vouchers, contracts, collective negotiations agreements and individual employment contracts, and public salary and. overtime information. Minutes of public meetings will be generally immediately after the minutes have been approved. Records which are not readily available or which will require a search of-records will

incl-uding employee available

"

be

made seven

available as soon [7] business days

as possible indicating

and the applicant will be provided with an interim keport the time which will be required to provide the records.

within

Except as otherwise record shall be: first page; all pages over when page, the request as provided a request

provided by law or regulation, the fee assessed for the duplication of a printed page to tenth page, $0.75 per page; eleventh page to twentieth page, $0.50 per twenty, $0.25 per page; for a police accident report there is an additional fee in person 39:4-13 I. in a format format of $5.00 for the first 3 page s and $1.00 for each additional

is not made by N.J.S.A. is for a copy in the

Where

other

than a photocopy, The cost will

reasonable be based

efforts

will be

made

to

provide the information the format requested.

/ /

requested.

on the costs

of producing

Where a legal determination must by law, the request will be reviewed The term "public records'" g_nerally

be made as to whether records by the Municipal Attorney. those records determined

are "public

records"

as provided

includes

to be public

in accordance

with

N.J.S.A. 47:1A-1. The term does not include employee personnel files, police investigation public assistance files or other matters in which there is a right of privacy or confidentiality agency or intra-agency advisory, consultative, or deliberative material or other material specifically exempted by law.

records, or interwhich is

The Applicant hereby acknowledges receipt of a copy of this form with the date on which the information is expected to be available and the estimated cost. The applicant hereby certifies that he or she has not been convicted of any indictable offense under the laws of this State, any other state or the United States and is not seeking government records containing personal information pertaining the victim or the victim's family as provided by N.J.S.A. 47:1A-1 et seq.. This form, when signed by the municipal official shall constitute a receipt for any deposit received.

The information Estimated Estimated Number Cast

requested of Pages

will be ready

on

Deposit [required where the anticipated cost of reproduction exceeds $5.00]

Applicant Date:

Municipal

Official " Date: