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This document is an Open Public Records Act (OPRA) request form for the Borough of Woodlynne, New Jersey. It outlines the process for requesting government records, including the requestor's information, record description, preferred delivery method, and certification statements. It also details fees associated with record duplication, potential deposit requirements, and reasons for denial. The form includes important notices regarding requestor rights and procedures for challenging denials.

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--- Document: Opra Form Document ---
Borough of Woodlynne
OPEN PUBLIC RECORDS ACT REQUEST FORM
200 Cooper Ave, Woodlynne, NJ 08107, USA
(856) 962-8300 & (856) 962-8763 (Fax)
jerry.fuentes@woodlynne.org
Luis Pastoriza
lmportant Notice
The last page of this form contains important information related to your rights concerning government records. Please read it carefully
R
uestor lnformation - Please Print
P
ent lnformation
Record Request lnformation: Please be as specilic as possible in describing the records being requested. Also, please note that your preferred
method of delivery will only be accommodated if the custodian has the technological means and the integrity of the records will not be
jeopardized by such method of delivery.
Notei lf you conlirmed above that the records sought are in connection with a legal prcceeding, identilication of that proceeding is
required below.
under penalty of N.J.S.A. 2C:28-3, I certify that
L lE neve tfr HAyE flOf been convicted of any indictable offense under the laws of New Jelsey, any
other state, or the United Statesi
2. l. or another person, D WLL / E WLL NOT use the requested government records for a commercial
purpose;
3. I fS AM I C) AM NoI seeking records in connection with a legal proceeding.
N4t
Last Name
State
E-mail
zip
City
Si nature
First Name
E-mailAddress
Mailing Address
Telephone
Preferred Delivery
US Mail
Date
Pick
Up
On-Site
lnspect
aximum Authorization Cost $
Select Payment [rethod
Check Money Order
Letter size pages - $0.05
per page
Legal size pages - $0.07
per page
Other materials (CD, DVD,
etc) - actual cost of material
Delivery / postage fees
additional depending upon
delivery type.
Extras: Special service charge
dependent upoo request.
Cash
Fees:
Delivery:
AGENCY USE ONLY
AGENCY USE ONLY
AGENCY USE ONLY
Est. Document Cost
Esi. Dolivery Cost
Esl, Extras Cost
Toral Est. Cost
Deposil Amouht
Estimated aalance
Deposil Date
Dlrposition Notes
Custodianr lf any parl of requesl cannol be
delivered in seven business days.
delailreasons here
ln Progress
Deflied
Filled
Open
Closed
Closed
Closed
Tracking lnformation
Rec'd Dale
Ready Dale
Total
Deposit
Ba16nce Due
Balance Paid
FAX


DEPOSITS
The custodian may require a deposit against costs for reproducing documents whenever the custodian anticipates that the documents requested
will cost in excess of $5 to reproduce. \LIIA 47:1A-s(f).
Where a special service charge is warranted under OPRA, that amount will be communicated to you as required under the statute. You have
the opportunity to review and object to the charge prior to it being incurred. lf, however, you approve of the fact and amount of the special
service charge, you may be required to pay a deposat or pay in full prior to reproduction of the documents.
YOUR REQUEST FOR RECORDS IS DENIED FOR THE FOLLOWING REASON(S):
(To be completed by the Custodian of Records - check the box oI the numbered exemption(s) as they apply to the records requested. lf
multiple records are requested, be specific as to which exemption(s) apply to each record. Response is due to requestor as sogn as
possible, but no laler lhan seven (7) or fourteen (14) business days. See page 5 for additional response details)
I]n
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N.ILSJL 47:1A-1.1
lnter-agency or intra-agency advisory, consultative or deliberative material
Legislative records
Law enforcement records:
E Medical examiner photos
Q Criminal investigatory records (however, N.J.S.A.47:1A-3(b) lists speciric criminal investigatory information which must be
disclosed)
f, Victims' records and/or OPRA requests submitted by victims seeking their own records
Personal firearms records or personal identifying information connected to any license authorizing hunting with a firearm.
Trade secrets and proprietary commercial or financial information
Any record within the attorney-client privilege
Administrative or technical information regarding computer hardware, tablets, telephones, electronic computing devices, software
applications, and networks or devices operation them which, if disclosed would jeopardize computer security
Emergency or security information or procedures for any buildings or facility which, if disclosed, would jeopardize security of the building
or facility or persons therein
Security measures and surveillance techniques which, if disclosed, would create a risk to the safety or persons, property, electronic
data or software
Security alarm system activity and access reports, including video footage the disclosure of which does not compromise the integrity of
the security system
lnformation which, if disclosed, would give an advantage to competitors or bidders including detailed or itemized cost estimates prjor to
bid opening
lnformation generated by or on behalf of public employers or public employees in connection with;
El Any sexual harassment complaint flled with a public employer
! 
Any grievance filed by or against an employee
Ef Collective negotiations documents and statements of strategy or negotiating
lnformation that is a communication between a public agency and its insurance carrier, administrative service organization or risk
management offlce
lnformation that is to be kept confidential pursuant to court order
Certificate of honorable discharge issued by the United States govemment (commonly Form DD-214 or NGB-22) filed with a public
agency
Oath of allegiance, oath of office, or other affirmation; except that full name, title, and oath date.
Priva
lnformation:
Social security numbers
Credit card or debit card numbers
Bank account information
Month and day of birth
Personal e-mail address required by a public agency for govemment applications, services, or progE,ms
Telephone numbers
Drivers' license numbers
Primary or secondary addresses for covered persons or immediate family members per N.J.S.A. 47:18-1 (Daniel's Law)
Portion of any document disclosing personal information of any person provided to a public agency for sole purpose of receiving offlcial
notifications
Lists (including personal information) of persons identifying as in need of special assistance in the event of an emergency maintained
by a municipality or county
Portjon ofany record disclosing the personal identifying information ofa person under 18 years old
Personal identifying information contained on domestic animal permits, license, and registrations.
l\retadata
New Jersey Firemen's Association financial relief applications
Owner and maintenance manuals
HIPAA information and indecent or graphic images of a person's intimate parts as defined in N.J.S.A. 47:1A-5.2
Certain records of higher education institutions:
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Research records
Questions or scores for exam for employment or academics
Charitable contribution information
Rare book collections gitted for limited access
Admission applications
fT


f] Student records, grievances or disciplinary proceedings revealing a students' identification
Biotechnology trade secrets N.J.S.A. 47:lA-1.2
Convicts requesting their victims' records Nj:LSIL 47:lA-2.2
Ongoing investigations of non-law enforcement agencies (must prove disclosure is inimical to the public interest) !j:L]EJ! 47:'lA-3(a)
Public defender records_l!.lLqJL 47:1A-s(k)
Upholds exemptions contained in other State or federal statutes and regulations, Executive Orders, Rules of Court, and privileges
created by State Constitution, statute, court rule orjudicial case law-ltllglL 47:1A-9
Personnel and pension records (however, the following information must be disclosed:
. 
An individual's name, title, position, salary, payroll record, Iength of service, date of separation and the reason for such
separation, and the amount and type of any pension received
. 
When required to be disclosed by another law, when disclosure is essential to the pedormance of offlcial duties of a person
duly authorized by this State or the US, or when authorized by an individual in interest
. 
Data contained in information which disclose conformity with specific experiential, educational or medical qualillcations
required for government employment or for receipt of a public pension, but not including any detailed medical or psychological
information N.J.S.A. 47:1 A-i 0
LJ!9IL 47:1A-l
! 
"a public agency has a responsibility and an obligation to safeguard from public access a citizen's personal information with which it
has been entrusted when disclosure thereof would violate the citizen's reasonable expectation of privacy."
Burnett v. Cou ntv of Berqen , 198 N.!. 408 (2009). Without ambiguity, the court held that the privacy provision "is neither a preface nor
a preamble." Rather, "the very language expressed in the privacy clause reveals its substantive nature; it does not offer reasons why
OPRA was adopted, as preambles typically do; instead, it focuses on the law's implementation." "Specifically, itimposesan obligation
on public agencies to protect against disclosure of personal information which would run contrary to reasonable privacy interests."
Executive Order No.21 (Mccreevey 2002)
S Records where inspection, examination or copying would substantially interFere with the State's ability to protect and defend the State
and its citizens against acts of sabotage or terrorism, or which, if disclosed, would materially increase the risk or consequences of
potenlial acts ol sabotage or teronsm.
I 
Records exempted from disctosure by State agencies' proposed rules.
Executive Order No.26 (McGreevey 2002)
Certain records maintained by the Offlce of the Govemor
Resumes, applications for employment or other information concerning lob applicants while a recruitment search is ongoing
Records of complaints and investigations undertaken pursuant to the Model Procedures for lnternal Complaints Alleging Discrimination,
Harassment or Hostile Environments
lnformation relating to medical, psychiatric or psychological history, diagnosis, treatment or evaluation
lnformation in a personal income or other tax return
lnformation describing a natural person's finances, income, assets, liabilities, net worlh, bank balances, financial history or activities, or
creditworthiness, except as otherwise required by law to be djsclosed
Test questions, scoring keys and other examination data pertaining to the administration of an examination for public employment or
licensing
Records in the possession of another department (including NJ Office of lnformation Technology or State Archives) when those records
are made confidential by regulation or EO 9.
Other Exemption(s) contained in a State statute, resolution of either or both House of the Legislature, regulation, Executive order,
Rules of Court, any federal law, federal regulation or federal order pursuant to !-:LqA 47:1A-9(a).
(Please provide detailed information regarding the exemption from disclosure for which you are relying to deny access to government records
lf multiple records are requested, be specific as to which exemption(s) apply to each record.)
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lf, jn addition to requesting records under OPRA, you are also requesting the government records under the common law, please check the
box below.
A public record under the common law is one required by law to be kept, or necessary to be kept in the discharge of a duty imposed by law, or
directed by law to serye as a memorjal and evidence of something written, said, or done, or a written memorial made by a public officer authorized
to perform that function, or a writing llled in a public offlce. The elements essential to constitute a public record are that it be a written memorial,
that it be made by a public omcer, and that the officer be authorized by law to make it.
f] Yes, I am also requestiog the documents under common law.
lf the information requested is a "public record" under common law and the requestor has a legally recognized interest in the subject matter
contained in the material, then the material must be disclosed if the individual's right of access outweighs the State's interest in preventing
disclosure.
Please set forth your interest in the subjecl matter contained in the requested material
Note that any challenge to a denial of a request for records under the common law cannol be made to the covernment Records
Council, as the Government Records Council only has jutisdiction to adjudicate challenges to denials of OPRA requests. A challenge
to the denial of access under the common law can be made by filing an action in Superior Court,
REQUEST FOR RECORDS UNDER THE COMMON LAW


1. All "government records" as detined in Njl=rSA 47:14-1.1 are subject to public access under the Open Public Records Act
("OPRA"), unless specifl cally exempt.
2. A request for access to a government record under OPRA must be in writing, hand-delivered, mailed, transmitted electronically,
or otherwise conveyed to the appropriate custodian. N.J.S.A. 47:1A-5(g). ln accordance with OPRA, custodians willgenerally
have seven (7) business days to respond. unless;
. 
The requestor seeks "immediate access" records as outlined in N.J.S,A. 47:'1A-5(e); where the custodian must
respond "immediately" disclosing responsive records not to exceed twenty-four (24) months old.
. 
The requestor seeks information required to be disclosed by N.J.S.A. 47:'1A-3(b), where the custodian must respond
disclosing the information within twenty-four (24) hours or as a soon as practical;
. 
The requestor is a seeking records for a "com mercial purpose" as defined in N.J. S A 47l.14-1.1 , where the response
time frame is fourteen (14) business days, but the custodian shall notity the requestor of the additional time within
seven (7) business days. N.J.S.A.47:1A-s(i). However, the response time frame can be reduced to seven (7)
business days upon payment of no more than two times the cost to produce the responsive records.
. 
The requestor is seeking records requiring review for compliance with "Daniel's Law" (N.J.S.A. 47:'lB-1. el seg.),
where the response time frame is fourteen (14) business days, but the custodian shall notify the requestor of the
additionaltime within seven (7) business days. N.JTSA 47:1A-5(i).
. 
Fire district employing one or fewer full-time employees serving as custodians may add seven (7) business days to
the seven (7) or fourteen (14) business day response time frames.
The applicable response time does not commence until the custodian receives the request form. N.J.S.A. 47:1A-s(h). lf you
submit the request form to any other officer or employee, the recipient must either forward the request to the appropriate
custodian or direct you to the appropriate custodian. &L
3. Requestors are not required to use this OPRA request form; however, a written equivalent not containing the form requirements
of N.J.S.A. 47:1A-s(f) and N.J.S.A. 47:1A-5(g) may be denied by a custodian.
4. Requestors may submit requests anonymously. A request submitted anonymously shall nol be considered incomplete.
N.J.S.A. 47:'1A-5(0. lf you elect not to identify yourself accurately or provide an accurate address, e-mail address, or telephone
number, the custodian is not required to respond until you reappear before ihe custodian seeking a response to the original
request. Further, anonymous requestors are prohibited from liling a complaint with either the GRC or the Courts. N.J.S.A.
47 t1A-6.
5. The fees for duplication of a "government record" in printed form are listed on page lof this form. The custodian will notify you
of any special service charges or other additional charges authorized by State law or regulation betore processing your request.
Payment shall be made by cash, check or money order payable to the responding agency.
6. You may be charged a prepayment or deposit when a request for copies exceeds $5.00. The custodian will contact you and
advise you of any deposit requirements. You agree to pay the balance due upon delivery of the re6ords.
7. Under OPRA, a custodian must deny access to a person who has been convicted of an indictable offense in New Jersey, any
other state, or the United States, and who is seeking government records containing personal information pertajning to the
person's victim or the victim's family. N.J.S.A. 47:1A-2.2. This includes anonymous requests for said information.
8. By law, the responding agency must notify you that it grants or denies a request for access to government records wathin
applicable response time frame after the custodian receives the request. lf the record requested is in storage, the custodaan
will advise you within seven (7) or fourteen (14) business days after receipt of the request when the record can be made
available and the estimated cost for reproduction within no more than twenty-one (21) business days from date of notification.
N.J.S.A. 47:1A-5(i).
9. You may be denied access to a govemment record if your request would substantially disrupt agency opeGtions and the
custodian is unable to reach a reasonable solution with you. N.J.S.A.47:1A-5(g).
10. lf the custodian is unable to comply with your request for access to a govemment record, they will indicate the specific bases
for denial on the request form or other written correspondence and send it to you.
1 1 . Except as otherwise provided by law or by agreement with the requester, if the custodian fails to respond to you in writing
within seven (7) or fourteen (14) business days of receiving a request, the failure to respond is a deemed denial of your request.
N.J.S.A. 47:1A-5(g); N.J.S.A. 47:1A-5(i).
12. lf your request for access to a government record has been denied or unfilled within the seven (7) orfourteen (14) business
days required by law, you have a right to challenge the decision by the responding agency to deny access. At your option, you
may either: 1) institute a proceeding in the Superior Court of New Jersey; or 2) file a complaint with the Government Records
Council ("GRC") by completing the Denial of Access Complaint Form. All questions regarding complaints filed in Superior
Court should be directed to the Court Clerk in your County. Questions regarding the GRC's Denial of Access Complaint process
can directed to the GRC toll-free telephone at 866-850-0511, by mail at PO Box 819, Trenton, NJ,08625, by e-mail at
Government.Records@dca.ni.oov. or at their web site at www.state.ni.us/orc. The Council can answer general inquines about
OPRA.
13. lnformation provided on this form may be subject to disclosure under the Open Public Records Act.