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2. PUBLIC RECORDS REQUEST
   The Cosumnes Community Services District (District) understands and supports the public’s right to access the public records created and maintained by the District in the course of their normal business. It is the goal of the District to provide service in a transparent manner, which includes timely access to requested records in accordance with the California Public Records Act (PRA), Government Code Sections 6250 to 6270. California law designates that the majority of the District’s records be available for public disclosure. These laws also stipulate certain types of records that are exempt from public disclosure, such as personnel records, records related to current litigation or current real estate negotiations, and such.

4. Medical Report and Billing Records

   Requests for medical reports and ambulance billing records may be submitted to our Ambulance Billing Vendor. For more information, visit the Public Records page.

6. INSTRUCTIONS
   Complete the following information and click submit when done.
8. CONTACT INFORMATION
10. First Name*
11. Last Name*
13. Address*
15. City*
16. State*
17. Zip*
19. Phone Number*
20. Email Address*
22. Contact Preference

    Please select your preferred method of communication and receipt of records.

    1. Email

    1. Phone

    1. US Mail
24. RECORDS REQUESTED
    Please select the best category that best fits the records request. If you are unaware of the category, select "N/A". To expedite the request, please enter one (1) Public Request for each category. Thank you.
26. CATEGORY*

    1. Administrative Services
    2. Fire
    3. Finance
    4. Recreation / Community Services
    5. Other
    6. Park Operations
    7. N/A
28. INCIDENT

    Is this record request related to an incident?

    1. Yes
    2. No
30. INCIDENT DATE & TIME
    INCIDENT DATE & TIME

    INCIDENT DATE & TIME
31. INCIDENT LOCATION
33. Describe the records you wish to receive. In order to expedite the search for the records, please be as specific as possible.
35. REQUEST DESCRIPTION*
37. SUBMIT REQUEST
39. Date of Request
    Date of Request
41. Signature of person making the request
    I/We the undersigned, request documents as indicated and agree to pay for copies provided at the rate of ten cents ($0.10) per page or the cost of reproduction to use an outside vendor if necessary plus shipping. Payments can be made via check or cash.
43. Do you agree?*

    By clicking I agree, you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your electronic signature is valid and binding upon you to the same force and effect as a handwritten signature.

    1. I Agree
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

* indicates a required field