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. Requested Records*

    Please provide as specific a description as possible of the record you are requesting, including record titles and dates. A reason for the request may assist staff in procuring the most pertinent information.

18. Department*

    1. Administration
    2. Building, Planning, Zoning, and Codes
    3. Finance
    4. Fire
    5. Municipal Court

    1. Parks and Recreation
    2. Police
    3. Public Works
    4. Other
20. Delivery Method

    1. Email (PDF)
    2. Fax
    3. Paper Copy

    Requests will be fulfilled via electronic correspondence unless otherwise specified.

    Applicable fees include, per 1-602(b), 1-603(c), and 1-603(a) of Eudora City Code:

    Inspection of Open Records: $15/hour

    Faxing: $.25/sheet

    Copying: $.25/sheet

22. Signature of person making the request*

    In accordance with Kansas Open Records Act, Chapter 171, 1983 Kansas Session Laws, I hereby request access to the specified public records.

    The City will respond to this request within three (3) working days.

24. 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.

    Additionally, I hereby acknowledge that I am aware the K.S.A. 45-230 provides:

    "No person shall knowingly sell, give or receive for the purpose of selling or offering for sale, any property or service to persons listed therein, any list of names and addresses contained therein, or derived from public records."

    I understand and acknowledge that a violation of this law is a Class C Misdemeanor and can subject the violator to prosecution and imprisonment of up to 30 days and a fine of $500.

    1. I Agree
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26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field