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Ada County Treasurer's
Request Form For Public Record Disclosure
PUBLC RECORDS REQUEST
PUBLIC REQUESTS REQUEST
In order to examine or copy a record maintained by this office, the following form must be completed.
If more than three (3) working days are needed to retrieve or locate the record, the record shall be provided
within ten (10) working days following the request, unless it is determined that the record requested
cannot be disclosed.
Name: ________________________________________ Date: ______________
________________________________________
(please print)
Address: _____________________________________ Phone: _____________
Street (Daytime #)
_________________________ __________
City State Zip
Record(s) requested:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
--------------------------------------------------------------------------------------------------------------------------------Bottom Portion to be Filled Out by Ada County Treasurer
Date Received: _____________ Received by: _____________________________________
Deputy Treasurer
If initialed opposite, more than three (3) working days are needed ____________
to retrieve the requested record(s). The record(s) will be provided Initials
within ten (10) working days from the date of the request, unless
it is determined that the record(s) may not be disclosed.
Photocopies for 9 pages are free and up to 10 or more @ $.15 each from the first page.
# of copies made _____ Amount due $______ Amount paid $ ______
Certificate of Mailing
I hereby certify that the original request was deposited in the United States mail; postage prepaid,
this ______ day of _________________, 20___.
______________________________
Deputy Treasurer
Request To Examine/Copy Public Records
To: Ada County ___________________________________
Date: _____________________________________________
I hereby request, pursuant to Idaho Code Section 9-338, to examine and/or copy the following public records.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
[ ] These records specifically pertain to myself.
[ ] I wish to merely examine these records.
[ ] I wish copies of these records.
Printed Name: ______________________________________
Mailing Address: ______________________________________
______________________________________
______________________________________
______________________________________
Telephone Number: (____) ________________________
SEND COMPLETED REQUEST FORM TO:
P O BOX 2868, BOISE, IDAHO, 83701
FAX TO:
208-287-6809
EMAIL TO:
propertytaxquestions@adaweb.net
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