Free PRAR.pmd - Kansas

Kansas Secretary of State

Paper Records Access Request
Name City State Address Zip Phone

PRAR

E-mail _________________________ Legislators only: Capitol Room # ________ Capitol Phone _______________________

Notice
K.S.A. 45-230 prohibits using names and addresses derived from public records for This form is designed to be completed certain commercial purposes. This includes using public records to sell property or online, printed from your computer and services. Persons are also prohibited from obtaining public records with the intention of making the records available to a third party for such purposes. Violation of this submitted to the appropritate office. Please law is a civil offense punishable by fine. Violations will be referred to the attorney be sure all pertinent information is general or district attorney for prosecution. The undersigned hereby requests access to the records described below and certifies is completed, select 'Print' to print the that the undersigned has a right of access to the records. The undersigned further certifies that the information obtained from the records will not be used for a prohibited form. Selecting 'Reset' will clear the entire purpose. Sign below to request a record under the Open Records Act, K.S.A. 45-215 et seq., and to indicate your understanding of the conditions outlined above.
Signature Date

completed before printing. Once the form form.

Do not write in this space

Reset

Print

Records Request:
Please provide a specific description of the records you want to inspect or copy.

__________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________

Fees to Access Records: · The fees will be determined by the division having access to the requested records. · Prior to receiving the requested records you will be informed of the amount due. · Notice: There is a $25 service fee for all returned checks.
Please return to: Secretary of State, Attn: Diane Minear, 120 SW 10th Ave., Topeka, KS 66612-1594 Pre-paid account #_______________. For more information e-mail: [email protected], (785) 296-4801. Credit card number: __________________________________ Expiration date: _________________________ ___________
Month Year

Date received:
Total Amount Due: __________________

Completed by:
Date Paid: _______________

Date completed:

10/31/08 jls

K.S.A. 45-220