• Secure Electronic Public Records Request

    State of Nevada
  • Date of Request*
     - -

  • The e-mail you use must be verified.

    A validation e-mail will be sent to the address you entered. It will come from noreply@jotform.com. After you click "the Verify" button, you will see instructions. Follow the instructions until you see a green message like this E-mail has been verified successfully. Do not proceed until your e-mail has been verified. Click here if you need more help.

  • Best e-mail to use*
  • Format: (000) 000-0000.

  • Documents Requested

    Please be as specific as possible and include the names and dates of documents, if you know them. This will help us to respond to your request as quickly as possible.
  • *

  • Important: Print this form before submitting it.

    You will receive a copy of this form in your email. If you want to save it before submission, please print the form to a .pdf file., or download and use the .pdf version of this form instead.
  •   

  • This section is to be filled in on a printed copy by the employee receiving the request.

    (Please print as a .pdf file. Use the phrase SEPRR followed by a dash a the requestor's name - followed by a dash and the date and store on our network. Example: SEPRR - Davis - Joan - 04-21-2015)
  • Fees charged:
  • Fees Received:
  • Date request completed:
  • Employee Signature

  • This section to be filled in on a printed copy by the Attorney General, if the document is known as a public record.

    Please fill in and return to the Parole Board by inter-office mail.

  • To be used for determination of access....
  • Date Sent:

  • Date Returned:

  • Access Granted:   Yes; No.  (Circle one)
  • Should be Empty: