Requestor Details ( indicates required field):



Description of Records Requested :


Please provide a description of the records you would like to inspect or have produced. Please indicate the type of record you are seeking, the title or name of the document, dates, document numbers, facility or location of the subject property. Specificity in a request will assist in speeding up the search and potentially reduce the fees for the request. You may upload an attachment if necessary.


If your request concerns an environmental site or facility, please submit as much of the following information as possible: the site or facility name, identification number, and the precise location (address, latitude/longitude, or legal description). This information can usually be found using the KDHE Environmental Interest Finder (KEIF) website at https://maps.kdhe.state.ks.us/keif/.


Description

Please check the appropriate Division that this request should be routed to. If you are uncertain which Division is most appropriate or if more than one applies, please select "KORA Officer”.


 


File(s) To Include (Optional):


Please upload any relevant documents to your request. (docx,doc,pdf,msg)
You must have IE 10 or higher or Google Chrome in order to drag and drop files. Change browsers or use the upload button above to attach files.

Desired File Format :


  Select Format


Fees : Please note KDHE assesses fees for staff time, copies, shipping, and materials necessary to provide the records. KDHE may require advanced payment for these services. KDHE will contact you if the amount will exceed the authorized amount indicated below.

  I hereby authorize KDHE to fulfill the above request and bill me for any fees, provided the fee amount does not exceed  
.
Prohibited Uses : K.S.A. 45-230 prohibits the use of names and addresses derived from public records for certain commercial purposes. Violation of this law can result in a civil penalty not to exceed $500 for each violation.
Before submitting your request, please ensure that all information provided is correct. Requests with incomplete or incorrect contact information may not be processed.


By checking the "I agree" checkbox below, requester does not intend to, and will not, use any list of names or addresses contained in or derived from the records or information for the purpose of selling or offering for sale any property or service to any person listed or to any person who resides at any address listed, or sell, give or otherwise make available to any person any list of names or addresses contained in or derived from the records or information for the purpose of allowing that person to sell or offer for sale any property or service to any person listed or to any person who resides at any address listed.