Georgia Department of Public Safety ____________ (Date)
959 E. Confederate Ave. SE
Atlanta, GA 30315
Pursuant to the state open records law, Ga. Code Ann. Secs. §50-18-70 to 50-18-76, I respectfully write to request the following information:
Dear Custodian of Records:
Please provide a copy of the list of streets and permit the Department of Public Safety has on file for ____________________ (name the department) during ___________________ (year you were ticketed). (Be as specific as possible with your request, if you would like any other information list the information here)
If your agency does not maintain these public records, please let me know who does and include the proper custodians name and address.
As provided by the open records law, I will expect your response within three (3) business days.
If this providing this information will cost more than _____________ (enter dollar amount) please alert me as soon as possible.
If you choose to deny this request, please provide a written explanation for the denial including a reference to the specific statutory exemptions upon which you rely.
Sincerely,
Name ___________________________
Address _________________________
Email Address ____________________
Phone Number ___________________