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2. First Name*
3. Last Name*
5. Address 1*
7. Address 2
9. City*
10. State*
11. Zip*
13. Phone Number*
14. Email Address*
16. Description of Records Requested*
    Please describe the public records you wish to receive. In order to expedite the search for the records, please be as specific as possible.
18. Department*

    1. Animal Control
    2. Assessor
    3. Board of Commissioners
    4. Clerk
    5. Community Corrections
    6. Community Development
    7. County Counsel
    8. Developmental Disabilities

    1. District Attorney
    2. Emergency Management
    3. Extension/Experiment Station
    4. Fairgrounds
    5. Finance
    6. Human Resources/Risk Management
    7. Information Technology
    8. Justice Court

    1. Juvenile Department
    2. Library
    3. Maintenance
    4. Museum
    5. On-Site
    6. Parks
    7. Planning
    8. Property Sales

    1. Public Health
    2. Public Works
    3. Sheriff
    4. Solid Waste
    5. Surveyor
    6. Tax Collector
    7. Treasurer
    8. Veterans Services
20. Fees:
    Payment is to be made in advance unless prior arrangements are made. Research Fee: Hourly staff rate + overhead (35%) if more than 15 minutes of staff time is required. Photocopies: $0.25/page* CD/DVD: $3.00* Electronic Format records may be provided at no cost, if less than 15 minutes staff time is involved.*
22. *Unless superseded by a specific departmentally adopted fee schedule
24. If the request involves research prior to giving an estimate of the costs, and it is determined that the costs will exceed $25.00, the custodial department shall prepare an estimate and contact the requester to receive approval/denial to proceed with the records request.
26. 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.

    1. I Agree
28. Signature of person making the request
    Pursuant to ORS 192.324, the County will acknowledge receipt of the request within five (5) business days.
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30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit Submit and Print

* indicates a required field