TOWN OF
PINETOP-LAKESIDE
Request is hereby made for the following public records:
(Indicate document name, page numbers, address and permit number where applicable.
Attach 8 ˝” by 11” sheet for additional space.)
Pursuant to A.R.S. Section 39-121.03, the applicant certifies that said documents: (Check one)
□ Will not be used for a commercial purpose.
□ Will be used for the following commercial purpose:
Applicant’s Name (print)
Applicant’s Signature
Address
Phone Number
Date
**********
Arizona Public Records Law, A.R.S. § 39-121.01 et
seq. requires that persons requesting records for a commercial purpose must
provide a certified statement setting forth the commercial purpose for which
the records are requested. As used in
this section, commercial purpose is defined as: “the use of a public record for
the purpose of sale or resale or for the purpose of producing a document
containing all or part of the copy, printout or photograph for sale or the
obtaining of names and addresses from such public records for the purpose of
solicitation or the sale of such names and addresses to another for the purpose
of solicitation or for any purpose in which the purchase or can reasonably
anticipate the receipt of monetary gain from the direct or indirect use of such
public record. Commercial purpose does
not mean the uses of a public record as evidence or as research for evidence in
an action in a judicial or quasi-judicial body of this state or a political
subdivision of this state.”
A person certifying the noncommercial purpose must
certify that the request is not made for business, monetary, economic,
commercial or trade reasons, and that neither the requester nor any person
which may utilize the information contained in the record as a result of access
by the requester will receive economic benefit or gain from utilization of
information contained in the record.
An
individual who knowingly falsifies his certification for a document under these
provisions is guilty of a class 6 felony.