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Public Records Reproduction Request

LISTING OF PUBLIC RECORDS REPRODUCTION REQUEST

Payment must be received in full with a copy of the request form. Requested documents/information will only be provided after payment is received in full. Please make checks or money orders payable to the arizona state board of funeral directors and embalmers. 

Directory of licensed funeral establishments (some formatting restrictions may apply. Contact the board’s office with any questions.)

REQUESTING PARTY: PLEASE READ AND NOTE THE FOLLOWING

Pursuant to a.R.S. §39-121.03, laws 1977, chapter 54 §2 (effective 05/17/77), any person requesting copies, printouts or photographs of public records must provide a verified statement as to whether the use of such reproduction will be for commercial or noncommercial purposes. 

A person providing a verified statement that the reproduction will not be used for a commercial purpose will be furnished such reproduction for a reasonable fee, not exceeding a commercial rate for like services. A person providing a verified statement setting forth the commercial purpose for which the reproduction will be used may be furnished such reproductions at the discretion of the custodian of records for a charge reflecting the following:

  1.  A portion of the cost to the state of arizona for obtaining the documents or records to be reproduced;
  2. A reasonable fee covering the cost of time, equipment and personnel in making the reproductions; and
  3. The value of the reproduction on the commercial market. 

If the custodian of a public record believes that the commercial purpose of a reproduction is a misuse of public records or an abuse of the right to receive them, he or she may refuse a request for reproduction of such records for said commercial purpose and may request the governor to prohibit the furnishing of reproductions for such commercial purposes by an executive order. If an executive order is not issued within thirty (30) days of the custodian’s application, the requesting party will be furnished such reproductions for the commercial purpose set forth in his or her verified statement.

Pursuant to a.R.S. §39-121.03(d) defines “commercial purpose” as the “use of a public record for the purpose of sale or resale or for the purpose of producing a document containing all or part of the copy, printout or photograph for sale or the obtaining of names and addresses from public records for the purpose of solicitation or the sale of names and addresses to another for the purpose of solicitation or for any purpose in which the purchaser can reasonably anticipate the receipt of monetary gain from the direct or indirect use of the public record. Commercial purpose does not mean the use of a public record as evidence or as research for evidence in an action in any judicial or quasi-judicial body.

Important: a.R.S. §39-121.03(c) provides that: “a person who obtains a public record for a commercial purpose without indicating the commercial purpose or who obtains a public record for a noncommercial purpose and uses or knowingly allows the use of such public record for a commercial purpose or who obtains a public record for a commercial purpose and uses or knowingly allows the use of such public record for a different commercial purpose or who obtains a public record from anyone other than the custodian of such records and uses it for a commercial purpose shall in addition to other penalties be liable to the state or the political subdivision from which the public record was obtained for damages in the amount of three times the amount which would have been charged for the public record had the commercial purpose been stated plus costs and reasonable attorney fees or shall be liable to the state or the political subdivision for the amount of three times the actual damages if it can be shown that the public record would not have been provided had the commercial purpose of actual use been stated at the time of obtaining the records.”

* The penalty for perjury is a fine of not less than $500 nor more than $5,000, or state imprisonment for not less than one nor more than 14 years, or both.

 Pursuant to a.R.S. §32-4404(c) a person may obtain additional public records related to any licensee, including dismissed complaints and nondisciplinary actions and orders, by contacting the board directly.


The Americans with Disabilities Act: Persons with disabilities may request reasonable accommodations such as sign language interpreters. Requests should be made as early as possible to allow time to arrange the accommodation. This document is available in alternative format upon request.

Requesting Party
Confirmation
Agreement
I agree that I have read the information and instruction sheet accompanying this form and understand the contents therein.

I further declare that the copies or other reproductions of the public records described above and which I have requested are to be used solely for: 

I further declare that such copies or reproductions will not be used directly or indirectly for a different purpose other than described above. I further declare under penalty of perjury that the foregoing is correct and true.
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