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AZ.gov Arizona's Official Website Arizona Office of Administrative Hearings
Arizona Office of Administrative Hearings AZ.gov Arizona's Official Web Site
Arizona Office of Administrative Hearings


 

1. Date:


2. Public Records


From: 3. Last Name: 4. First Name:

5. Contact Number:

6. Email Address:

7. Mailing Address:

8. Non-Commercial Purpose Commercial Purpose


9. Request for Inspection Request for Copies

10. OAH Docket Number:

11. Record(s) to be inspected or copied


12. Other Information you wish to relay.


13. Placing a mark in the signature space below constitutes my certification that I have read the document and that the contents are true to the best of my knowledge or belief. I further certify that I have reviewed the definition of commercial and non-commercial purposes; that I understand the the cost of a copy reproduction for all documents is at $0.50/page for 8.5 x 11", or the cost incurred by the OAH for replication of oversized documents; and that the cost of replication must be paid prior to replication.
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