BOROUGH OF WALDWICK ADMINISTRATION BUILDING 63 FRANKLIN TURNPIKE WALDWICK, NJ 07463 REQUEST FOR ACCESS TO GOVERNMENT RECORDS Please fill
in all appropriate information requested and mail to the above address or email to: pjaegge@waldwicknj.org. Once received, your request will be forwarded to the appropriate department and you will be notified within seven business days. Copies requested will be charged in accordance with the attached schedule. No.:___________ Date Received______________________ Date of Response _______________ NAME_______________________________________ COMPANY NAME______________________________ ADDRESS ___________________________________ ___________________________________ DAYTIME TELEPHONE NO. _____________________ INFORMATION REQUESTED: ( ) Copy of Minutes (specify board or entity, date, topic or other identifying information)
( ) Copy of Ordinance or Resolution (specify date, number of other identifying information)
( ) Police Accident Report Fee: _________________________________ Date/Location _________________________________________________ ( ) Other (specify) ______________________________________________ __________________________________________________________
( ) License Information (specify) _________________________________ __________________________________________________________ __________________________________________________________ Information on a Specific Property: Address: _____________________ Block __________ Lot __________
Additional property information, please attach list: ( ) Property Record Card ( ) Deed ( ) Other (specify)
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 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 the 7 business days, you will be provided with a response with that information within the 7 business days. Some records requested have specific fees and 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 the 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 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 I interim report within 7 business days indicating the time which will be required to provide the records. Except as otherwise provided by law or regulation, the fee assessed for the duplication of a printed record shall be: $.05 per page for 8-1/2 x11 copies, $.07 per page for 8-1/2 x 14 copies; for a police accident report there is an additional fee when the 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. When a request is 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 cost 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 record 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 deliberative 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 law of this State, any other State of the United States and is not seeking government records containing personal information pertaining to the victim or the victims 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 required. The information requested will be ready on Estimated number of pages Estimated cost Deposit (required when the anticipated cost of reproduction Exceeds #5.00) _________________________________ _________________________________ _________________________________ _________________________________
_______________________________________________ Applicant Date: __________________________________________
_________________________________ Municipal Official Date: ____________________________
