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REQUEST TO EXAMINE/COPY PUBLIC RECORD(S) For Police records, please fill out the Moscow Police Department Public Records Request Form found here: Revised July 2025 The City of Moscow complies with the Idaho Public Records Act (Idaho Code Title 74, Chapter 1) regarding appropriate time limitations for public records requests. By law, information gained through this request cannot be used for the purpose of compiling a mailing list or telephone list without obtaining permissions from each individual. All requests to copy or examine public records must be made in writing. Please fill out this form completely. Failure to include all required information requested herein may result in your request being denied pursuant to I.C. § 74-102(4). REQUESTER’S INFORMATION (please print): Full Name Date of Request Mailing Address City State Zip Email Address Phone Number Are you a resident of the State of Idaho as defined by I.C. § 74-101(15)? ☐ Yes ☐ No If you marked yes, please read and attest to the following: I certify under the penalty of perjury pursuant to the law of the State of Idaho that I am a resident of the State of Idaho or employee of a resident of the State of Idaho as defined by I.C. § 74-101(15). If I am signing this attestation utilizing an electronic signature, I understand that this electronic signature is valid and binding upon me to the same force and effect as a handwritten signature. (signature of requestor) REQUESTED DOCUMENTS (Please be as specific as possible with dates, property addresses, and details regarding the information you wish to receive). PLEASE NOTE: Advance payment of a fee may be required when it is estimated that more than two hours of labor or more than one hundred (100) copies of paper records will be necessary in completing the request for residents. Non-residents may be charged all actual costs associated with processing public record requests and may require an advance payment of the estimated actual costs. ☐ I would like to personally examine these records. The City will call with appointment options when records have been compiled and are ready for review. ☐ I would like copies of records provided to me in electronic form, if available. ☐ I would like copies of records provided to me in printed form. I acknowledge, declare and certify under the penalty of perjury pursuant to the law of the State of Idaho, with my signature below, that the foregoing information is true and correct and that the records sought by this request will be utilized only for purposes allowed by law and noted above. Further, I agree to pay any associated fees as noted above, including mailing if appropriate. Signature Date Return completed form to City Clerk, City of Moscow, PO Box 9203, Moscow ID 83843 or [EMAIL REDACTED]. If you have questions, please call the City Clerk at [PHONE REDACTED].