PUBLIC-RECORDS REQUEST WORKSHEET

This is a blank self-service worksheet, not a submission to FlockIt.info.
Download and edit it locally. No request is sent by downloading this file.
Check the agency's official website for the correct recipient and process.
Public-records rights and exceptions depend on the applicable jurisdiction.

Agency: [name and jurisdiction]
Time period: [start and end dates]

I request copies of the following existing records concerning [agency]'s
Flock Safety services for the period above. Please use the selections below
that describe the records sought; remove categories you do not need.

- Executed orders, agreements, amendments, and renewal or non-renewal notices.
- Records establishing installation, validation, and service commencement dates.
- Deployment Plans and records identifying contracted and installed quantities.
- Invoices, payment records, grant awards/amendments, and funding approvals.
- Current use, retention, sharing, access-control, and auditing policies.
- Records supporting a specified public performance claim: [identify claim/date].

Please provide electronic copies where available. If portions are withheld,
please identify the basis for withholding and provide disclosable portions.
Please advise me of any anticipated fees before incurring them.

Reply contact: [use only the contact information required by the agency's process]

Keep a local copy of the final request and any acknowledgment or responses.
This worksheet does not establish that any record exists or must be disclosed.