Records Request Please enable JavaScript in your browser to complete this form.Name *FirstLastAddress *City *State *Zip *Phone *Email *Method of Delievery *EmailUSBUS Mail (First Class)US Mail (Certified)Other than “Email”, additional charges will apply.Delivery Frequency *One Time RequestSent Monthly (Requires new request each Jan 1)Records Requested *Consent and Responsibilities *I have read this and give my consent and understand my responsibilities in requesting these documents.CERTIFICATE OF COMPLIANCE WITH K.S.A. 45-220-(c) & K.S.A. 45-230 I understand that no person shall receive, for the purposes of selling or offering for sale, any property or service to person listed therein, any list of names or addresses contained in or derived from a public record. I also understand that violation of the statute prohibiting the unlawful use of names derived from a public record is a civil violation. In accordance with these provisions, I certify that I do not intend to, and will not, use any list of names or addresses contained in or derived from public records for the purpose of selling or offering for sale, any property or service to any person listed or to any person who resides at any address listed; neither will I sell, give, or otherwise make available to any person, any list of names or addresses contained in or derived from the records or information for the purpose of allowing that person to sell or offer for sale any property or service to any person listed or to any person who resides at any address listed, except under authority of the limited circumstances provided in K.S.A. 45-230. NOTE: Kansas law provides that a public agency may charge and require advance payment of a fee for providing access to, or furnishing copies of public records. The Open Records Fee Schedule may be viewed at www.pleasanttownshipbuco.org/fees.Submit All records will be disclosed unless an exemption applies pursuant to KSA 45-221 Records Request Schedule Fees