Town of Horizon City Public Information Request (Texas Government Code, Chapter 552) Instructions

Enter any additional comments, notes, or relevant details that do not fit elsewhere on the form.

Enter the total dollar amount for the charges shown in the top portion of the charges table.

Enter the number of minutes of mainframe computer resource usage to be charged.

Enter the total dollar amount charged for mainframe computer resource usage. Fill only if 'Mainframe Minutes' is greater than 0.

Check this box if the computer resource charges are for Mainframe usage (billed per minute).

Enter the number of hours of PC or LAN computer resource use to be charged.

Enter the total dollar amount charged for the PC or LAN computer resource use. Fill only if 'PC or LAN Hours' is greater than 0.

Enter a brief description or notes explaining the computer resource charges being requested (e.g., what work was performed and for which system).

Enter the subtotal dollar amount for all Computer Resource Charges (e.g., Mainframe and PC or LAN) in this section. Fill only if 'Mainframe Total', 'PC or LAN Total Charge' are greater than 0 (any fields).

Enter any details or special instructions for the records you want copied or duplicated (for example, what you need copied and any preferred copy format).

Enter the date this request is being processed by the department.

Enter the internal reference number assigned to this request.

Enter the date the city received this request.

Enter the date the city responded to this request.

Enter the date the requested records were picked up, if applicable.

Enter notes about payment status or payment details for this request.

Enter the internal department reference number assigned to this public information request.

Enter the date the department recorded or processed this public information request.

Enter the total amount charged for the first miscellaneous supply or charge item. Fill only if 'First Miscellaneous Supply/Charge Quantity', 'First Miscellaneous Supply/Charge Unit Cost' are filled (all fields).

Enter the description of the first miscellaneous supply or charge item.

Enter the quantity for the first miscellaneous supply or charge item.

Enter the unit cost for the first miscellaneous supply or charge item. Fill only if 'First Miscellaneous Supply/Charge Quantity' is greater than 0.

Check this box when you are entering the first miscellaneous supply/charge line item (description, quantity, unit cost, and total) on this form.

Enter a brief description of the fourth miscellaneous supply or charge item.

Enter the quantity or number of units for the fourth miscellaneous supply or charge item.

Enter the total cost amount for the fourth miscellaneous supply or charge item. Fill only if 'Fourth Miscellaneous Supply/Charge Quantity' is greater than 0.

Enter any internal notes or comments related to this request for department/city personnel use.

Enter the number of labor hours spent locating, compiling, reproducing, and redacting records (more than 50 pages).

Enter the total dollar amount charged for labor spent locating, compiling, reproducing, and redacting records. Fill only if 'Labor Hours (Locating/Compiling/Reproducing/Redacting)' is greater than 0.

Check this box when labor charges are being applied for locating, compiling, reproducing, and/or redacting records for a request involving more than 50 pages.

Enter the number of labor hours charged for programming work.

Enter the total dollar amount charged for programming labor. Fill only if 'Programming Labor Hours' is greater than 0.

Check this box when you are charging labor time for programming work related to fulfilling the request.

Enter the labor charge amount that the 20% overhead rate will be applied to.

Enter the total overhead charge amount (20% of the labor charge). Fill only if 'Programming Labor Total', 'Labor Total (Locating/Compiling/Reproducing/Redacting)' are greater than 0 (any fields).

Enter the subtotal dollar amount for the Labor charge section (including any applicable overhead charge). Fill only if 'Programming Labor Total', 'Labor Total (Locating/Compiling/Reproducing/Redacting)', 'Overhead Charge Total' are greater than 0 (any fields).

Enter the subtotal dollar amount for all Miscellaneous Supplies & Charges listed in this section. Fill only if 'First Miscellaneous Supply/Charge Total', 'Second Miscellaneous Supply/Charge Total', 'Third Miscellaneous Supply/Charge Total', 'Fourth Miscellaneous Supply/Charge Total' are greater than 0 (any fields).

Enter the number of Digital Video Discs (DVDs) being requested.

Enter the total dollar amount charged for the requested DVDs. Fill only if 'Nonstandard-size DVD Quantity' is greater than 0.

Check this box if the request includes a nonstandard-size digital video disc (DVD) item to be provided.

Enter the number of diskettes requested.

Enter the total amount due for the requested diskettes. Fill only if 'Nonstandard-size Diskette Quantity' is greater than 0.

Check this box if you are requesting records on a diskette as a nonstandard-size medium.

Enter the number of non-rewritable CDs (CD-R) requested.

Enter the total charge amount for the non-rewritable CDs (CD-R). Fill only if 'Nonstandard-size Non-rewritable CD (CD-R) Quantity' is greater than 0.

Check this box if you are requesting records to be provided on a non-rewritable CD (CD-R) as a nonstandard-size item.

Enter a brief description of the nonstandard-size other charge item being billed.

Enter the quantity or number of units for the other charge item.

Enter the unit cost to be charged for each unit of the other charge item. Fill only if 'Other Charges Quantity' is greater than 0.

Enter the total dollar amount for this other charge line item. Fill only if 'Other Charges Quantity', 'Other Charges Unit Cost' are filled (all fields).

Enter the number of other electronic media items being requested at actual cost.

Check this box when the unit cost for “Other electronic media” will be entered as an actual per-item amount (instead of a fixed fee). Fill only if 'Other Electronic Media Quantity' is greater than 0.

Enter the total dollar amount charged for the other electronic media items at actual cost. Fill only if 'Other Electronic Media Quantity', 'Other electronic media (Actual Cost) - Actual unit cost (per ea.)' are filled (all fields).

Check this box if you are requesting or charging for “Other electronic media” that will be billed at actual cost.

Enter the total charge for the oversize paper pages requested. Fill only if 'Oversize Paper Quantity' is greater than 0.

Check this box when the requested copies are on oversize paper larger than 8½ x 14 and should be charged under the Nonstandard-size oversize paper line.

Enter the number of oversize paper pages requested (larger than 8½ × 14).

Enter the number of nonstandard-size photographs requested at actual cost.

Check this box if the unit cost for the requested photographs will be charged at actual cost per photograph (each). Fill only if 'Photographs (Actual Cost) Quantity' is greater than 0.

Enter the total charge amount for the nonstandard-size photographs at actual cost. Fill only if 'Photographs (Actual Cost) Quantity', 'Photographs (Actual Cost) - Unit Cost (per each)' are filled (all fields).

Check this box if you are requesting nonstandard-size photographs and want this item included in the charges.

Enter the total charge for the rewritable CDs (CD-RW) line item. Fill only if 'Nonstandard-size - Rewritable CD (CD-RW) Quantity' is greater than 0.

Enter the number of rewritable CDs (CD-RW) requested.

Check this box if you are requesting a nonstandard-size copy on a rewritable CD (CD-RW).

Enter the number of specialty paper pages requested for the nonstandard-size specialty paper (actual cost) item.

Enter the total actual cost to charge for the specialty paper item. Fill only if 'Specialty Paper Quantity', 'checkbox_d637_41c8' are filled (all fields).

Check this box if the request includes nonstandard-size specialty paper that will be charged at actual cost.

Enter the subtotal dollar amount for all nonstandard-size charges listed in this section. Fill only if 'Nonstandard-size Diskette Total', 'Nonstandard-size - Rewritable CD (CD-RW) Total', 'Nonstandard-size Non-rewritable CD (CD-R) Total', 'Nonstandard-size DVD Total', 'Other Electronic Media Total Cost', 'Oversize Paper Total', 'Specialty Paper Total Cost', 'Photographs (Actual Cost) Total', 'Other Charges Total' are greater than 0 (any fields).

Enter a brief description of the postage or shipping charges being billed.

Enter the subtotal dollar amount for postage or shipping to be included in the total charges. Fill only if 'Postage/Shipping Actual Cost' is greater than 0.

Enter the actual dollar amount charged for postage or shipping.

Enter a mark or text to indicate you want the requested records delivered to you by email (to the email address provided above).

Check this box if you want the requested records mailed to you at the address listed above.

Enter a mark or text to indicate you want the requested records delivered to you by mail (to the address provided above).

Check this box if you (or your representative) will pick up the requested records when notified they are ready.

Enter a mark or text to indicate you want to pick up the requested records in person (or through a representative) when notified they are ready.

Check this box if you want the requested records faxed to you (intergovernmental requests only).

Enter the fax number where you want the requested records sent (intergovernmental requests only). Fill only if 'Faxed' is 'Yes'.

Enter a mark or text to indicate you want the requested records delivered to you by fax.

Enter a brief summary of the specific public information or records you are requesting.

Provide a detailed description of the records you are requesting, including any identifying details such as dates, topics, departments, addresses, names, or case/reference information to help locate them.

Enter the requestor's street address (including apartment, suite, or unit number if applicable).

Enter the city for the requestor's mailing address.

Enter the state for the requestor's mailing address.

Enter the ZIP code for the requestor's mailing address.

Enter the requestor’s fax number.

Enter the requestor’s email address.

Enter the requestor’s phone number.

Enter the full name of the person making the public information request.

Enter the requestor's identification or driver's license number.

Enter a brief description of the second miscellaneous supply or charge item.

Enter the quantity (number of units) for the second miscellaneous supply or charge item.

Enter the cost per unit for the second miscellaneous supply or charge item. Fill only if 'Second Miscellaneous Supply/Charge Quantity' is greater than 0.

Enter the total charge amount for the second miscellaneous supply or charge item. Fill only if 'Second Miscellaneous Supply/Charge Quantity', 'Second Miscellaneous Supply/Charge Unit Cost' are filled (all fields).

Enter the date on which the requester signed this public information request form.

Enter the number of Motor Vehicle Accident Reports being requested for the standard-size charges calculation.

Enter the total dollar amount to be charged for the Motor Vehicle Accident Reports requested. Fill only if 'Motor Vehicle Accident Report Quantity' is greater than 0.

Enter the number of standard-size paper copy pages requested (up to 8½ x 14).

Enter the total charge amount for the standard-size paper copies requested. Fill only if 'Standard-size Paper Copies Quantity' is greater than 0.

Enter any notes or a description related to the standard-size charges requested (e.g., details about paper copies or motor vehicle accident reports).

Enter the subtotal dollar amount for all Standard-size charges listed in this section. Fill only if 'Standard-size Paper Copies Total Charge', 'Motor Vehicle Accident Report Total Charge' are greater than 0 (any fields).

Enter a description of the third miscellaneous supply item or charge being billed.

Enter the quantity or number of units for the third miscellaneous supply item or charge.

Enter the unit cost for the third miscellaneous supply item or charge. Fill only if 'Third Miscellaneous Supply/Charge Quantity' is greater than 0.

Enter the total amount for the third miscellaneous supply item or charge. Fill only if 'Third Miscellaneous Supply/Charge Quantity', 'Third Miscellaneous Supply/Charge Unit Cost' are filled (all fields).

Enter a brief description or notes summarizing what the total charges are for.

Enter the total number of items or units used to calculate the total charges.

Enter the cents portion of the total charges amount (no sales tax).

Enter the dollar portion of the total charges amount (no sales tax). Fill only if 'Standard-size Charges Subtotal', 'Nonstandard-size Charges Subtotal', 'Labor Charges Subtotal', 'Computer Resource Charges Subtotal', 'Miscellaneous Supplies & Charges Section Subtotal', 'Postage/Shipping Subtotal' are greater than 0 (any fields).