Los Alamos County

Barb Ricci
Designated Custodian of Records
1000 Central Avenue, Suite 190
Los Alamos, NM 87544
(505) 663-1891

Date of Request: 

Name & Address of Requestor

* Name:

* Mailing P.O. or Street Address:

Check one option below:

 I would like to inspect and then possibly request a copy of the documents listed below

OR

I waive my right to inspect - please furnish me with a copy of the documents listed below - if cost will exceed $, then please notify me in advance of making any copies **

**  Requestor in entitled to fifteen (15) free copies for documents 11"x17" in size or smaller.  Each copy in excess of 15 pages will be charged forty cents ($.40) per page for documents 11"x17" in size or smaller.  If a requestor wants a document larger than 11"x17", the cost per copy shall be $1.50 per square foot.  At the Custodian's discretion and based upon size and volume of the request, the copies may be made by the County using a local copy service, in which case the requestor shall reimburse the County's actual cost.

List records requested below:(Please provide a detailed and specific description of the records sought)

I understand that I must pay the County any fees for copies I request. prior to those copies being provided.  
Payment shall be provided in cash or check only.