Forms

Model Forms:

OIP has created model forms that may be used to request access to a government record or to reply to a requester. To view or print these forms, click on the titles below.

Forms for the Public (UIPA):

Forms for Government Agencies (UIPA):

  • Notice to Requester (rev 5/8/14) (MS Word) – fillable form
  • Notice to Requester (rev 5/8/14) (pdf)
  • Acknowledgment to Requester (rev 5/8/14) (MS Word) – fillable form
  • Acknowledgment to Requester (rev 5/8/14) (pdf) Note:  The acknowledgment form should be used only when an agency is unable to complete the Notice to Requester within the ten business day deadline, due to extenuating circumstances, and needs to extend the deadline by up to an additional ten business days.  A Notice to Requester must still be sent by the end of the extended response period.

Forms for Boards (Sunshine Law):

Other Forms (UIPA):

  • UIPA Record Request Log FORM FY2016 (Excel) – use this log to track record requests (not the sample log).
    Use this form to track and report record requests received between July 1, 2015 and June 30, 2016.
    The only revisions to the FY 2016 Log are in the drop-down menus for the “department” and “agency” (Columns A and B), which now include the Legislature and its attached agencies, the four counties, and the Oahu Metropolitan Planning Organization. These drop-down menus may be continually revised as necessary; if you do not find your department or agency on the menus, please contact Michael Little at OIP. The other Log columns remain the same.  Note: To adjust your view of the Log spreadsheet, change the zoom view to 65% or 100% or some other view (click on View, then Zoom, and select a zoom level). (NOTE: This form replaces the Agency Report on Fees and Waivers of Fees.)  To see other Log materials, go to the UIPA Record Request Log page.
  • Agency Report on Fees and Waivers of Fees (pdf) (pursuant to HAR 2-71-3, regarding fees charged for search, review, and segregation of records).  NOTE: This form has been replaced by the UIPA Record Request Log.

If you require an auxiliary aid or accommodation due to a disability, please contact (808) 586-1400 or email oip@hawaii.gov.