Government

Public Records Request Form Template

A public records request form is a form that collects a requester's contact details, a clear description of the records they want, the date range, the department that holds them and the preferred delivery format so a government agency can search for and release records under open records law. This template prompts requesters to be specific, which helps clerks find the right records and avoid long back-and-forth.

Use this template — freeTry it first
17 questions
3 pages
~5 min
To fill in
Minimal layout
Mobile-ready
Free
No credit card
Public Records Request form beside a photo of a desk lamp lighting a newspaper on a desk

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Who it's for

City and county clerks, records officers, school districts, police departments, public universities and other agencies that handle FOIA or open records requests.

  • The online records request page on a city or county website
  • Police and fire departments handling report requests
  • School districts receiving requests for board records and emails
  • Small towns replacing paper request forms at the clerk's counter

What this template asks

Every question can be changed, removed or reordered once it's yours.

Requester

  1. First name*

    Short text

  2. Last name*

    Short text

  3. Email*

    Email

  4. Phone

    Phone number

    Optional

  5. Organization

    Short text

    Optional. News outlet, company or nonprofit

  6. Mailing address

    Long text

    Optional. Only needed for paper copies

  7. Which best describes you?

    Multiple choice

    Optional. Can affect fees in some places

    • Member of the public
    • News media
    • Educational or research
    • Commercial use
    • Prefer not to say

Records requested

  1. Department or office*

    Dropdown

    • Clerk's office
    • Police department
    • Fire department
    • Building and planning
    • Public works
    • Finance
    • Human resources
    • Parks and recreation
    • Not sure

  2. Describe the records you are requesting*

    Long text

  3. Records from

    Date

    Optional

  4. Records to

    Date

    Optional

  5. Supporting documents

    File upload

    Optional. e.g. a prior letter or reference document

Delivery and fees

  1. How would you like to receive the records?*

    Multiple choice

    • Electronic copies by email
    • Paper copies by mail
    • Inspect in person
    • Pick up copies

  2. Maximum fee you agree to without being contacted

    Number

    Optional

  3. Are you requesting a fee waiver?*

    Multiple choice

    • No
    • Yes

  4. Reason for fee waiver

    Long text

    Only if you requested a waiver

  5. Acknowledgement*

    Checkboxes

    • I understand that records may be redacted and fees may apply

Tips for more responses

  1. 1

    Use the response table and edit history to track each request's status and keep a dated log of when it was received and closed.

  2. 2

    Send requesters an automatic email copy of their submission so they have a dated receipt of the request.

  3. 3

    Embed the form on your records page next to your fee schedule and response timelines so requesters know what to expect.

Questions

What should a public records request form include?

The requester's name and contact details, a specific description of the records wanted, a date range, the department or office likely to hold them, the preferred format (electronic copies, paper copies or in-person inspection), any fee limit, and whether a fee waiver is requested and why.

Do I have to say why I want public records?

In the US, most federal and state open records laws do not require a reason for a request, though a reason may help with a fee waiver. Rules differ between countries and states, so check the law that applies to the agency.

How long does an agency have to respond to a records request?

It depends on the law. The federal FOIA generally allows 20 working days, while state laws range from a few days to a 'reasonable time'. Agencies can often extend the deadline for large requests, so check your local rules.

How do I make a records request more likely to succeed?

Be specific: name the type of document, the people or offices involved, keywords and a narrow date range. Broad requests like 'all emails' take longer, may cost more and are more likely to be narrowed or refused.

Is this public records request template free?

Yes. Copy it into a free Dculus Forms account, change anything you like and start collecting responses. No credit card is needed.

Can I change the questions?

Yes. Your copy opens in the form builder, where you can add, remove and reorder questions, change the layout and add your own branding.

Where do the responses go?

Responses arrive in your Dculus Forms workspace. You can export them to Excel or CSV, send them to Google Sheets or a webhook, and get email notifications.

Can I host it myself?

Yes. Dculus Forms is open source (GPLv3), so you can run it on your own servers and keep every response in your own database.

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