The clerk of the Town of ________, ________ County, Wisconsin, by this notice states that the clerk of the Town of ________ has been designated under
s. 19.33, Wis. stats., as the legal custodian of records for the Town of ________, except that elected officials are the custodians of their own records of office and chairpersons of committees of elected officials are custodians of the records of the committee [insert if alternative 3 below is used and except as noted below].
The public may obtain information and access to records in the custody of the clerk or other appropriate legal custodian, make requests for records, or obtain copies of records, and learn the costs of obtaining copies of records from the town clerk or other appropriate legal custodian as follows:
[Include either Alternative 1 or Alternative 2, as applicable.]
[Alternative 1] The town clerk maintains regular office hours of ____ _.m. to ____ _.m., ___day to ___day, except legal holidays, at ______________.
[Alternative 2] [choose Option A or B, as applicable]
(Option A) The town clerk does not maintain regular office hours at the location where records in the custody of the town clerk are kept. The Town has established ____ _.m. to ____ _.m. each ___day [not less than two consecutive hours per week], during which access to the records of the Town in the custody of the clerk is permitted, except legal holidays when access shall be permitted on the [following
or preceding] day. The location of the records is: ______________. [if desired The Town requires 24 hours' advance written or oral notice of intent to inspect or copy a record to the town clerk.]
(Option B) The town clerk does not maintain regular office hours at the location where records of the Town are kept. The town clerk will permit access to Town records in the custody of the clerk upon at least 48 hours' written or oral notice to the town clerk of the intent to inspect or copy a record. The location of the records in the custody of the clerk is ________________.
[Alternative 3] [Include if the town clerk is not the sole custodian of the town's records. Insert Option A, B, or C, as applicable, and, in all cases when Alternative 3 is included, the table following Option C.]
The legal custodians for the records of the Town agencies and departments designated in the table below are as shown in the table.
(Option A) The designated legal custodians maintain regular office hours, and provide access to records of the listed agency or department in their custody at the location and during the hours stated in the table below, except legal holidays.
(Option B) The designated legal custodians do not maintain regular office hours at the location where records of the agency or department in their custody are kept. The Town has established the times designated in the table below [not less than two consecutive hours per week] during which access to the records of the agencies and departments in the custody of the designated custodian is permitted, except legal holidays when access shall be permitted on the [following or preceding] day. The location of the records for each department or agency [if notice is required and contact information for the custodian] is as designated in the table below. [if desired The Town requires 24 hours' advance written or oral notice of intent to inspect or copy a record to the appropriate legal custodian.]
(Option C) The designated legal custodians do not maintain regular office hours at the location where records of the agency or department in their custody are kept. The Town will permit access to the records of the agencies and departments in the custody of the designated custodian upon at least 48 hours' written or oral notice to the legal custodian of the intent to inspect or copy a record. The location of the records for each department or agency and contact information for the custodian is as designated in the table below.
[Include in all cases.] As required under
s. 19.34 (1), Wis. stats., each Town Local Public Office
* is listed below. The public may obtain information and access to records in the custody of elected officials and chairpersons of committees of elected officials as the custodians of their own records of office, make requests for records, or obtain copies of records, and learn the costs of obtaining copies of records from the elected official or chairperson in accordance with the contact information designated as follows:
[Include in all cases.] The following are the fees for satisfying record requests under
s. 19.35, Wis. stats.:
Dated this ______ day of ________, 20__.
[Signature of town clerk]
Note: “Local public office” is defined in
s. 19.32 (1dm), Wis. stats., as:
19.32 (1dm) “Local public office” has the meaning given in
s. 19.42 (7w), and also includes any appointive office or position of a local governmental unit in which an individual serves as the head of a department, agency, or division of the local governmental unit, but does not include any office or position filled by a municipal employee, as defined in
s. 111.70 (1) (i).
And “local public office” is defined in
s. 19.42 (7w), Wis. stats., as:
19.42 (7w) “Local public office” means any of the following offices, except an office specified in sub. (13):
(a) An elective office of a local governmental unit.
(b) A county administrator or administrative coordinator or a city or village manager.
(c) An appointive office or position of a local governmental unit in which an individual serves for a specified term, except a position limited to the exercise of ministerial action or a position filled by an independent contractor.
(cm) The position of member of the board of directors of a local exposition district under subchapter II of chapter 229 not serving for a specified term.
(d) An appointive office or position of a local government which is filled by the governing body of the local government or the executive or administrative head of the local government and in which the incumbent serves at the pleasure of the appointing authority, except a clerical position, a position limited to the exercise of ministerial action or a position filled by an independent contractor.
I. TO BE COMPLETED BY PERSON REQUESTING ACCESS TO OR COPY OF RECORD IN POSSESSION OF THE TOWN OF ________, ________ COUNTY, WISCONSIN
Description of the record(s) to be inspected and/or copied:
Please note: A request “is deemed sufficient if it reasonably describes the requested record or the information requested. However, a request for a record without a reasonable limitation as to subject matter or length of time represented by the records does not constitute a sufficient request.” (
s. 19.35 (1) (h), Wis. stats.) The request may be made orally, but a request must be in writing before an action to enforce the request is commenced under
s. 19.37, Wis. stats.
Is the record or part of the record requested a personnel record of a town employee? Yes _____ No _____
Please note: A request may not be refused “because the person making the request is unwilling to be identified or to state the purpose of the request.” (
s. 19.35 (1) (i), Wis. stats.)
II. TO BE COMPLETED BY CUSTODIAN OR DEPUTY CUSTODIAN OF RECORD.
Municipal department, office, or work unit of any authority receiving request: (Include name of person receiving request)
Was the request acted upon within 10 days of the request? Yes _____ No _____
Action taken on request: ( ) Approved ( ) Approved in part and denied in part ( ) Denied
If the requested record was a personnel record, was the town employee notified of the request?
Yes ____ No ____*
Please note: For a denial, attach a copy of any statement of the reasons denying access to, a copy of, or other information contained in any public record covered by this request. If the request for the record was in writing, the denial determination is subject to review by mandamus under
s. 19.37 (1), Wis. stats., or upon application to the attorney general or a district attorney. (
s. 19.37 (4), Wis. stats.)
Reason for fee:
If a personal record request, the date and name and address of the town employee notified in writing as to the request and response, if any, received from the employee:
Note: See
s. 19.356, Wis. stats.
STATE OF WISCONSIN
Town of ________
________ County
The Town Board of the Town of ________, ________ County, Wisconsin, by this resolution, adopted by a majority of the town board on a roll call vote with a quorum present and voting and proper notice having been given, resolves and orders as follows:
The following fees for satisfying record requests under
s. 19.35, Wis. stats., are established:
The town clerk shall properly post or publish this resolution as required under
s. 60.80, Wis. stats.
Adopted this ______ day of ________, 20__.
[Signatures of town board]
Attest: [Signature of town clerk]
Notes: Copying costs of more than $.25 per page may be subject to legal challenge when the actual costs cannot be demonstrated to be more that $.25 per page.
This form does not establish costs for research or for creating a new record.
Under
s. 19.35 (3) (f), Wis. stats., an authority may require prepayment by a requester of any fees imposed under
s. 19.35 (3), Wis. stats., if the total amount exceeds $5.
STATE OF WISCONSIN
Town of ________
________ County
TO: ________ [Record requester]
Your request for access to the following record of the Town of ________, ________ County, Wisconsin, is granted: [specifically describe record here].
The requested record is subject to the provisions of
s. 19.356, Wis. stats., as the record is [choose Option A, B, or C, as applicable]
(Option A) a record containing information relating to an employee that is created or kept by the Town and that is the result of an investigation into a disciplinary matter involving the employee or possible employment-related violation by the employee of a statute, ordinance, rule, regulation, or policy of the employee's employer.
(Option B) a record obtained by the Town through a subpoena or search warrant.
(Option C) a record prepared by an employer other than the Town that contains information relating to an employee of that employer, unless the employee authorizes the Town to provide access to that information.
Under
s. 19.356, Wis. stats., all of the following conditions apply to the grant of access to the requested records:
1. Within 3 days after making the decision to permit access, the Town will serve written notice of that decision on any record subject to whom the record pertains.
2. Within 5 days after receipt of the notice under paragraph 1, the record subject may provide written notification to the Town of his or her intent to seek a court order restraining the Town from providing access to the requested records.
3. Within 10 days after receipt of the notice under paragraph 1, the record subject may commence an action seeking a court order to restrain the Town from providing access to the requested record. If the record subject commences such an action, you may intervene in the action as a matter of right. If you do not intervene in the action, the Town will notify you of the results of the proceedings in the action.
4. The Town will not provide access to the requested record within 12 days of sending the notice under paragraph 1. In addition, if the record subject commences an action as described in paragraph 3, the Town will not provide access to the requested record during the pendency of the action. If the record subject appeals or petitions for review of a decision of the court or the time for appeal or petition for review of a decision adverse to the record subject has not expired, the Town will not provide access to the requested record until whichever of the following occurs first:
a. Any appeal is decided.
b. The period for appealing or petitioning for review expires.
c. A petition for review is denied.
d. The Town receives written notice from the record subject that an appeal or petition for review will not be filed.
Dated this ______ day of ________, 20__.
[Signature of town clerk (or other record custodian)]
Note: Whenever a record request relates to an employee record, a determination must be made whether the record is of the type described in
s. 19.356 (2) (a) 1.,
2., or
3., Wis. stats., in which case, if the request is granted, notice must be given to the record subject and access cannot be provided to the record except as provided in
s. 19.356, Wis. stats., or if the record is of the type described in
s. 19.36 (10) or
(11), Wis. stats., in which case access must be denied.
If the record is not subject to
s. 19.356 (2) (a) 1.,
2., or
3., or
19.36 (10) or
(11), Wis. stats., but the record subject is a state or local elected official, the request is subject to
s. 19.356 (9), Wis. stats., and notice must be given to the record subject who is entitled to augment the record within 5 days of receipt of the notice. See the forms:
“Record subject” is defined in
s. 19.32 (2g), Wis. stats., as:
19.32 (2g) “Record subject” means an individual about whom personally identifiable information is contained in a record.
STATE OF WISCONSIN
Town of ________
________ County
TO: ________ [Record subject]
A request for access to the following record of the Town of ________, ________ County, Wisconsin, has been granted by the Town: [specifically describe record here].
You are the subject of the requested record.
The requested record is subject to the provisions of
s. 19.356, Wis. stats., as the record is [choose Option A, B, or C, as applicable]
(Option A) a record containing information relating to an employee that is created or kept by the Town and that is the result of an investigation into a disciplinary matter involving the employee or possible employment-related violation by the employee of a statute, ordinance, rule, regulation, or policy of the employee's employer.
(Option B) a record obtained by the Town through a subpoena or search warrant.
