TOWNSHIP OF DENNIS

571 Petersburg Road, P.O. Box 204

Dennisville, NJ 08214

(609) 861-9700 – (609) 861-9719 fax

 

REQUEST FOR ACCESS TO GOVERNMENT RECORDS

FOR MUNICIPAL USE ONLY

 

 

 

Date Received: _____________________________________            Date of Response:  ___________________________________

SEE INSTRUCTIONS ON THE OTHER SIDE

 

 

Name:_________________________________________________________________________

 

Address:_______________________________________________________________________

 

                _______________________________________________________________________

 

Telephone [Day]  ________________________________________________________________

 

Information 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 Report                                                                   Fee:  __________________________________

 

                               Identify Accident:  _______________________________________________________________________

 

     [_____]  Other [Specify]                 _______________________________________________________________________

 

                     ____________________________________________________________________________________________

 

                     ____________________________________________________________________________________________

 

                     ____________________________________________________________________________________________

 

     [_____]  License Information [Specify]        ________________________________________________________________

 

                     _____________________________________________________________________________________________

 

                     _____________________________________________________________________________________________

 

Information on a Specific Property      Address:________________________________________________________________

 

                                                                  Block:  __________________________              Lot:  ____________________________

 

     [_____]  Municipal Lien Search                                                                                      Fee:  $10.00

                    Municipal Lien searches are provided by the designated search officer and will be provided within 15 days after the

                    Request is received and the fee paid, as provided in N.J.S.A. 54:5-11, et seq.

 

     [_____]  List of Property Owners within 200’                                                                Fee:  ____________

                    As provided in N.J.S.A. 40:55D-12, the fee is greater of $ .25 per name or $10.00

 

 

 

 

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A request for access to or for a copy of Government records should be submitted on this form which has been adopted by the Municipal Clerk as the Custodian of records. Some records will be immediately available during normal business hours. Some records will require time to compile and to make the copies requested, but will normally be available during normal business hours and within (7) business days. If any document or copy which has been requested is not a public record or cannot be provided within (7) business days, you will be provided with a response with that information within the (7) business days. Some records requested have specific fees or other response times established by statute. There is no fee involved in simply inspecting a document during normal business hours. This request may be filed electronically. In general:

 

·          Immediate access is ordinarily available for to budgets, bills, vouchers, contracts, including collective negotiations agreements and individual employment contracts, and public employee salary and overtime information. Minutes of public meetings will be generally available immediately after the minutes have been approved.

 

·          Records which are not readily available or which will require a search of records will be made available as soon as possible and the applicant will be provided with an interim report within seven (7) business days indicating the time which will be required to provide the records.

 

·          Except as otherwise provided by law or regulation, the fees assessed for the duplication of a printed record shall be: first page to tenth page, $0.75 per page; eleventh page to twentieth page, $0.50 per page; all pages over twenty, $0.25 per page; for a police accident report there is an additional fee when request is not made in person of $5.00 for the first 3 pages and $1.00 for each additional page, as provided by N.J.S.A. 39:4-131.

 

·          Where a request is for a copy in a format other than a photocopy, reasonable efforts will be made to provide the information in the format requested. The cost will be based on the costs of producing the format requested.

 

·          Where a legal determination must be made as to whether records are “public records” as provided by law, the request will be reviewed by the Municipal Attorney.

 

The term “public records” generally includes those records determined to be public in accordance with N.J/S.A. 47:1A-1.  The term does not include employee personnel files, police investigation records, public assistance files or other matters in which there is a right of privacy or confidentiality or inter-agency or intra-agency advisory, consultative, or deliberate material or other material which is specifically exempted by law.

 

 

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 requested will be ready on          ______________________________________________________________

 

Estimated Number of Pages                                    ______________________________________________________________

 

Estimated Cost                                                          ______________________________________________________________

 

Deposit                                                                       ______________________________________________________________

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

 

 

 

______________________________________________                             _____________________________________________

Applicant                                                                                                        Municipal Official

 

 

 

Date:  ________________________________________                              Date:  _______________________________________

 

 

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