This is an HTML version of an attachment to the Open Public Records Act request 'Write in names'.


COUNTY OF OCEAN
REQUEST FOR GOVERNMENTAL RECORDS
This form should be completed and returned to the Custodian of Records in the Office of
the Clerk of the Board of Chosen Freeholders, Ocean County Administration Building, 1 01
Hooper Avenue, Room 328, Toms River, New Jersey 08753.
Please complete the information below. See reverse side for important information.
NAME:
(First Name)
(MI)
(Last Name)
.
ADDRESS:
(Street, PO)
(Town/City)
(State)
(zip)
PHONE NUMBER: (
)
(Work) (
)
(Home)
EMAIL ADDRESS:
Brief description of government record(s) you are requesting to copy
or inspect
(check one):
The Applicant hereby acknowledges receipt of a copy of this form with the
date on which the information is expected to be available and the estimated
cost. The Applicant hereby certifies that he or she has not been convicted of
any indictable offense under the laws of this State, any other state or the
United States and is not seeking government records containing personal
information pertaining to the victim or the victim's family as provided by

N.J.S.A. 47:1A-1 et seq.
Signature
  Date
July 1, 2002
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FOR COUNTY USE ONLY
Request Approved
Request Denied
Reason for denial:
Approximate date records will be available:
Fee:
$
Paid by:
Check
Cash
Money Order
Date
Custodian of Records
I
.
TIMEFRAME FOR RESPONSE TO A REQUEST
i
The Custodian of Records is required to grant or deny access to a government record no
later than seven (7) business days after receiving the request. If you do not provide a name,
address, telephone number or other means of contacting you, the Custodian of Records will

I
be unable to respond until you reappear in the Custodian of Records' Office seeking a
11
response to the original request.
If the government record is in storage or archived, you will be so advised within seven (7)
business days after the Custodian of Records receives your request. You will be advised by

the Custodian of Records when the record can be made available. If the record is not made
available by that time, access will be considered to be denied.
RIGHT TO APPEAL
If you wish to challenge a decision of the Custodian of Records denying access to a
government record, you may:
I
1)
Institute a proceeding to challenge that decision by filing an action in Superior
Court in New Jersey; or

r
2)
File a Complaint with the Government Records Council in the Department of
Community Affairs.

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July 1, 2002
...

OCEAN COUNTY BOARD OF CHOSEN FREEHOLDERS
Administration Building
101 Hooper Avenue
Toms River, New Jersey 08753
PUBLIC NOTICE
In accordance with Public Law 2001, Chapter 404, concerning public access to government
records, please be advised that the Custodian of Records in the Office of the Clerk of the
Board of Chosen Freeholders is located at the Ocean County Administration Building, 1 01
Hooper Avenue, Toms River, New Jersey 08753, business days between the hours of 9:00
a.m. and 4:30 p.m.
A request to inspect or copy government records should be submitted on the Request for
Government Records form which is available in the Office of the Custodian of Records.
A person who is denied access to a government record by the Custodian of Records may
institute a proceeding to challenge the Custodian's decision by filing an action in Superior
Court.
In lieu of filing an action in Superior Court, a person who is denied access to a government
record may file a complaint with the Government Records Council.
Date
Custodian of Records
Permanent Posting
Do Not Remove
July 1, 2002