Custodian of Records

California Public Records Act (CPRA) Request Form

Per the California Public Records Act (CPRA), I hereby request reproduction of the following records and, upon the production of said records, agree to pay the appropriate fees as follows:

Document reproduction fees: $0.10 per page (free if less than 10 pages) for single-sided paper documents** $0.05 per page (free if less than 20 pages) for double-sided paper documents** FREE for electronic files (PDFs, audio files, etc.) delivered via email or secured website ** Audio files may require electronic delivery.

Certified document fee: $10.00 surcharge will be added to any of the above fees if official LAHD certification is requested. Certified documents can be provided free electronically, please print out on a color printer.

Computer programming time fee (for complex requests requiring special programming): $70.00 per hour (We will notify you if computer programming time is required to fulfill your request. Payment for programming time must be made before documents will be produced.)

Please complete the form below to request public records under the CPRA. (Please note that the CPRA only applies to existing records held by LAHD and that some records may no longer exist due to their corresponding retention schedules. CPRA does not require a government body to create new information, to do legal research, or to answer questions. Requests for information [e.g. questions, clarifications, etc.] are not subject to the CPRA and should instead be directed to our public information hotline at (866) 557-7368 to be forwarded to the appropriate staff member.)

*** Required

Your Name
Phone Number	Please include area code
Organization Name	Optional. Only if applicable
Mailing Address	Required if paper records are requested
City, State, ZIP Code	Required if paper records are requested
Email Address	Required if electronic records are requested; if provided, we will communicate with you primarily via email
Description of Records Requested	Please provide a description of the records you are requesting, including document type (ie Notice to Comply, Inspection report, rent complaint, etc...), specific case numbers, property addresses, and APNs [Assessor Parcel Numbers] if available. If you can provide specific time periods (ie 2010-2014), it may help us retrieve the records more quickly)
If requesting hearing recordings, please provide the case number and/or date if known.
Do you require certified records?	Surcharge applies. Please see the fee list above. Certified Records? Yes No
Do you require paper records?	Printing fees apply. Please see the fee list above. Paper Records? Yes, single-sided paper printouts only Yes, double-sided paper printouts are OK No, electronic file delivery is OK
Is this request for your client?	On behalf of client? Yes, this is on behalf of my client, and I understand an authorization form must be uploaded. After submitting this request, you will immediately be sent an email that contains a link for uploading your authorization form.

California Public Records Act (CPRA) Request Form

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