Form Center

2. First Name*
3. Last Name*
5. Address
7. City
8. State
9. Zip Code
11. Phone Number*
12. Email Address*
14. Name of Defendant

    Please fill this out if you are requesting records for someone other than yourself. 

15. Birth Date
    Birth Date
17. Original Offense*

    What was the original charge/offense on your ticket?

19. Amended Offense

    Was your ticket amended to a lesser offense?

21. Date or Year of Incident*
    Date or Year of Incident
22. Date or Year Case Closed*
    Date or Year Case Closed
24. Case Outcome*

    What was the outcome of the case? Did you pay in full? Were the charges dropped?

26. Purpose of Request*

    Please explain why you need these records. The court can only provide you with public records but in some instances the entire file is not necessary. Please make sure to include the date you need this information.

28. Additional Notes and Comments

30. Charges:
    A charge for providing copies of public records has been set by the Governing Body. The fee schedule established by the City is $10 per records request, and $35 per research request. Research request fees pertain to cases that are not found in the digital database and require further inquiry into paper or state records. 

     The clerk will contact you via email or phone call to obtain additional information about your request within 3 business days. The clerk will inform you of the fee at that time. 

     Advisory:

    A list of names and addresses shall not be obtained from public records for the purpose of selling or offering for sale any property or service to the persons listed. This provision pertains to the names and addresses of businesses listed in the public records, as well as the individuals. K.S.A. 45-220(c) (2), K.S.A. 45-230.

    Signature of Requestor:
    I have made a written request for access to and/or copies of certain records identified above pursuant to the Kansas Open Records Act, and do hereby certify: 1) That I do not intend to and will not use any list of names or addresses contained in or derived from the records or information obtained from the City of Roeland Park for the purpose of selling or offering for sale any property or service to any person on the list or to any person who resides at any address on the list. 2) That I do not intend to and will not give, or otherwise make available, to any person any list of names or addresses contained in or derived from the records or information obtained from the City of Roeland Park for the purpose of allowing that person to sell or offer for sale any property or service to any person on the list or to any person who resides at any address on the list. 3) That I have been informed and am aware that to knowingly sell, give, or receive any list of names or addresses contained in or derived from public records for the purpose of selling or offering for sale any property or service to persons on the list is a violation of state statute (K.S.A. 45-230) and that any person violating the prohibition shall be liable for payment of a civil penalty.

Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field