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2. 
4. City of Jenks
   PO Box 2007
   211 N Elm St Jenks, OK 74037
   918-299-5883
6. Name*
7. Phone Number*
9. Address
10. Email Address*
12. This is a request for*

    1. Inspection only
    2. Copying only
    3. Inspection and copying
13. Preferred delivery method*

    1. Paper copy
    2. Electronic copy
15. Specifically list each item requested for inspection and/or copying.
17. Are these items for a commercial purpose?*

    1. Yes
    2. No
19. If yes, then specify which item(s) above will be used for commercial purposes
21. NOTICE TO REQUESTER
    A search fee and copying fee shall be charged to compile records for a commercial purpose or for a search request that will be unduly disruptive of City functions. Such search fee, including time transferring data, shall be $30.00 per hour or $7.50 per each quarter hour. A copying fee of $0.25 per uncertified page or $1.00 per certified page will be charged. Mechanical reproduction of certain items not readily able to be photocopied will be charged on an estimated basis to cover such actual reproduction costs and staff time. Data transferred to a flash drive shall cost direct cost. Payment shall be made prior to delivery. I agree to pay the charges for the above requested information.
23. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
25. Electronic Signature
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

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