Arizona Department of Homeland Security1802 W. Jackson Street, #117Phoenix, AZ 85007Phone: (602) 542-7013hs@azdohs.govOffice hours are Monday through Friday from 8:00 a.m. to 5:00 p.m. excluding State holidays. Requestor InformationIf you choose to have copies of the records mailed to you, the information entered below will be used for mailing purposes. Full Name * Street Address * Last Name * City * State * AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Phone * Email * Request Details What items are you requesting? * Describe the purpose for which you will use any requested records? * Commercial Requests Will these records be used for commercial*/business purposes? * Yes No Commercial/Business Questionnaire * YesNo Do you intend to sell or resell the documents? * Do you intend to sell or resell the documents? - Yes Do you intend to sell or resell the documents? - No Do you intend to sell or resell any of the information contained in the documents? * Do you intend to sell or resell any of the information contained in the documents? - Yes Do you intend to sell or resell any of the information contained in the documents? - No Do you intend to use any of the information contained in the public documents to produce a document for sale? * Do you intend to use any of the information contained in the public documents to produce a document for sale? - Yes Do you intend to use any of the information contained in the public documents to produce a document for sale? - No Do you intend to use any names or other information from the public documents for the purpose of solicitation? * Do you intend to use any names or other information from the public documents for the purpose of solicitation? - Yes Do you intend to use any names or other information from the public documents for the purpose of solicitation? - No Do you anticipate receiving monetary gain from the direct or indirect use of the public documents? * Do you anticipate receiving monetary gain from the direct or indirect use of the public documents? - Yes Do you anticipate receiving monetary gain from the direct or indirect use of the public documents? - No Pursuant to A.R.S. § 39-121.03 (C): A person who obtains a public record for a commercial purpose without indicating the commercial purpose or who obtains a public record for a noncommercial purpose and uses or knowingly allows the use of such public record for a commercial purpose or who obtains a public record for a commercial purpose and uses or knowingly allows the use of such public record for a different commercial purpose or who obtains a public record from anyone other than the custodian of such records and uses it for a commercial purpose shall in addition to other penalties be liable to the state or the political subdivision from which the public record was obtained for damages in the amount of three times the amount which would have been charged for the public record had the commercial purpose been stated plus costs and reasonable attorney fees or shall be liable to the state or the political subdivision for the amount of three times the actual damages if it can be shown that the public record would not have been provided had the commercial purpose of actual use been stated at the time of obtaining the records.* A.R.S. §39-121.03 (D): "commercial purpose" means the use of a public record for the purpose of sale or resale or for the purpose of producing a document containing all or part of the copy, printout or photograph for sale or the obtaining of names and addresses from public records for the purpose of solicitation or the sale of names and addresses to another for the purpose of solicitation or for any purpose in which the purchaser can reasonably anticipate the receipt of monetary gain from the direct or indirect use of the public record. Commercial purpose does not mean the use of a public record as evidence or as research for evidence in an action in any judicial or quasijudicial body.** In accordance with A.R.S. § 39-121.03 (A) additional fees will apply to commercial requests for copies, printouts or photographs of public records for a commercial purpose. Additional fees will be determined on a case-by-case basis and will take into consideration the following: 1. a portion of the cost to the public body for obtaining the original or copies of the documents, printouts or photographs; 2. a reasonable fee for the cost of time, materials, equipment and personnel in producing such reproduction; and 3. The value of the reproduction on the commercial market as best determined by the public body. Business Information Business Name: * Business Address: * Business City: * Business State: * AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Business Zip Code: * Type of Business: * Method of ReceiptPlease review the fee structure below before selecting a method. NO FEE:Visual inspection of records at 1700 W. Washington Street, Suite 210, Phoenix, AZ 85007. By Appointment Only.Call (602) 542-7013. Electronically available, small data files that do not exceed email restrictions. (Please note that multi-page/large data file requests may be only available via CD/DVD.)FEE:Photocopies of the records. $0.25 per page. CD/DVD are $25 eachIndividuals with functional needs that may require additional assistance, please contact the Department. Select the method in which you would like to receive the documents: * NO FEE FEE Type: * COPIES: Photocopies of the records. $0.25 per page CD/DVD: $25 each Receive Method: * I will pick up copies at 1700 W. Washington St. Suite 210, Phoenix, AZ 85007 Mail copies to me. I understand a postage fee will be added. Affirm Purpose of Use * Yes, I affirm that the public records requested will not be used for any other purpose than those described above. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
