OPRA REQUEST FORM

Fees
Letter size pages - $0.05 per page Legal size pages - $0.07 per page Other materials (CD, DVD, etc) – actual cost of material
Delivery
Delivery / postage fees additional depending upon delivery type.
Extras
Special service charge dependent upon request.

Requestor Information:

First Name: *
MI:
Last Name: *
Applicant Email:
Mailing Address:
City: *
State:
Zip: *
:
Telephone
Fax:
Preferred Delivery (Atleast one should be selected): *
Pick Up :
US Mail:
On-Site Inspect :
Fax:
E-mail :
If you are requesting records containing personal information, please circle one: Under penalty of N.J.S.A. 2C:28-3, *
I certify that I HAVE been convicted of any indictable offense under the laws of New Jersey, any other state, or the United States.
I certify that I HAVE NOT been convicted of any indictable offense under the laws of New Jersey, any other state, or the United States.
Record Request Information:
Please be as specific as possible in describing the records being requested. Also, please note that your preferred method of delivery will only be accommodated if the custodian has the technological means and the integrity of the records will not be jeopardized by such method of delivery: *
   
Please Enter the verification
code in the box *

Please read all reasons by which your request may be denied.
PAYMENT WIL BE REQUIRED PRIOR TO RELEASE OF DOCUMENTS.

Form Legends: More Info Error (Rollover to see the problem) Download PDF for Manual
Paper Application