Public Records Request

Office of the General Counsel

PO BOX 751

Portland, OR. 97207-0751

503-725-8050 (office telephone)

Request for Public Record

* Please Note: You must answer all questions before you can submit this form.

Date

Name

Organization

Address

Phone Number

Email

Preferred method of delivery:

Email

Fax

Regular Mail

Personal Inspection

Require Disability Accommodation as follows:

Is this request to a civil or judicial matter to which PSU is/may be a party?

Yes
No

Description of Records Requested: (Please be as specific as possible. Include names, timeframes, places, events, subjects, file designations or descriptions.)

Fee Waiver Request:

Yes (If yes, please explain reason)
No