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Sample Request Form for Texas
Address of Institution from which you wish to obtain documents
This request for records is made pursuant to Texas Civil Statutes article 6252-17a. I am the (list your title and the organization you are affiliated with. ________ (organization name) is a non-profit organization based (only say this if you are incorporated as a non-profit and/or are a tax-exempt organization) in __________, ____ (city & state where your organization is located). This organization is dedicated to educating the public about issues concerning animal rights.
The documents requested are: (list the documents you are requesting)
The requester is prepared to pay for all actual search and reasonable duplication fees up to an initial amount of twenty-five dollars ($25.00). If the fees will exceed this amount provide me with a detailed estimation of the fee, in advance before performing said work. However, Civ. St. art. 6252 17a, section 9(g), provides that: "Public records shall be furnished without charge or at a reduced charge if the governmental body determines that waiver of reduction of the fee is in the public interest . . ." The requester asserts at this time that ______________________ (organization name – list the name of your organization) is entitled to receive the above described records at no cost because such information is of great public interest and that dissemination of this information will benefit the general public by providing them with information for them to make an informed decision regarding the governments practices and animal rights in general.
The requester asserts that all records requested above are entitled to be given to him as they are public records as defined in Civ. St. Art. 6252-17a and do not fall into any of the express exemptions of Civ. St. Art 6252-17a, Section 3. Should you make an opposite decision, please segregate all claimed exempt portions, provide me with non-exempt portions, and provide me with a specific detailed statement of your position with specific reference to the exemptions listed Civ. St. Art. 6252-17a, section 3.
The Requester, further, requests a response to this request within ten (10) working days of its receipt as is required by Civ. St. Art. 6252-17a, sections 4 and 4a.
______________, __________ (list your name, and title within the organization you are affiliated with)
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