OPRA Request Form

Scroll down for important information regarding payment, deposits, and your rights concerning government records. Please read carefully.

Required fields are marked with a red asterisk ().

Requestor Information

First Name:

MI:

Last Name:

Email Address:

Street Address:

City:

State:

ZIP:

Phone:

Fax:

Preferred Delivery Method: Pick-Up US Mail On-Site Inspection Fax Email

If you are requesting records containing personal information, please select an option below to certify, under penalty of N.J.S.A. 2C:28-3, if you HAVE or HAVE NOT been convicted of any indictable offense under the laws of New Jersey, any other state, or the United States. I HAVE been convicted. I HAVE NOT been convicted.

Record Request Information

Please be as specific 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.

Request Information:

Request For Records Under The Common Law

If, in 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 serve as a memorial 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 filed in a public office. The elements essential to constitute a public record are that it be a written memorial, that it be made by a public officer, and that the officer be authorized by law to make it.

Yes, I am also requesting the documents under common law.

If 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 subject matter contained in the requested material:

Note that any challenge to a denial of a request for records under the common law cannot be made to the Government Records Council, as the Government Records Council only has jurisdiction 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.

Sign and Submit

To complete this form you must provide an electronic signature.

By checking this box, I consent to providing an electronic signature for this request and acknowledge that my electronic signature is binding.

Please enter your full name:

Signature

Date April 27, 2024

Payment & Deposits

Fees:

Letter size pages — $0.05 per page
Legal size pages — $0.07 per page
Other materials (CD, DVD, etc) — actual cost of material

Delivery:

Delivery/postage fees additional depending upon delivery type

Extras:

Special service charge dependent upon request

Deposits:

The custodian may require a deposit against costs for reproducing documents sought through an anonymous request whenever the custodian anticipates that the documents requested will cost in excess of $5.00 to reproduce.

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. If, however, you approve of the fact and amount of the special service charge, you may be required to pay a deposit or pay in full prior to reproduction of the documents.

Your Rights Concering Government Records

All government records are subject to public access under the Open Public Records Act ("OPRA"), unless specifically exempt.
A request for access to a government record under OPRA must be in writing, hand-delivered, mailed, transmitted via fax or email, to the Custodian of Records. The seven (7) business day response time does not commence until the records custodian actually receives the request. Any other officer or employee of New Jersey Schools Insurance Group does not have the authority to accept your request on behalf of NJSIG and will direct you to the Custodian of Records.
If it is necessary for the records custodian to contact you concerning your request, identifying information, such as your name, address and telephone number or an e-mail address is required. Where contact is not necessary, anonymous requests are permitted; except that anonymous requests for personal information are not honored based on N.J.S.A. 47:1S-2.2.
The fees for duplication of a government record in printed form are listed above. We will notify you of any special service charges or other additional charges authorized by State law or regulation before processing your request. Payment shall be made by cash, check or money order payable to New Jersey Schools Insurance Group.
You may be charged a 50 percent or other deposit when a request for copies exceeds $25.00. New Jersey Schools Insurance Group's custodian will contact you and advise you of any deposit requirements. You agree to pay the balance due upon delivery of the records. Anonymous requests require a deposit of 100 percent of estimated fees where the request is anticipated to involve fees in excess of $5.00.
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 pertaining to the person's victim or the victim's family. This includes anonymous requests for said information.
By law, New Jersey Schools Insurance Group must notify you that it grants or denies a request for access to government records within seven (7) business days after the agency custodian of records receives the request, unless an extension is requested. If the record requested is not currently available or is in storage, the custodian will advise you within seven (7) business days after receipt of the request when the record can be made available and the estimated cost for reproduction.
You may be denied access to a government record if your request would substantially disrupt agency operations and the custodian is unable to reach a reasonable solution with you.
If the New Jersey Schools Insurance Group is unable to comply with your request for access to a government record, the custodian will indicate the reasons for denial in writing.
Except as otherwise provided by law or by agreement with the requester, if the agency custodian of records fails to respond to you within seven (7) business days of receiving a request, the failure to respond is a deemed denial of your request.
If your request for access to a government record has been denied or unfilled within the seven (7) business days required by law, you have a right to challenge the decision by NJSIG to deny access. At your option, you may either institute a proceeding in the Superior Court of New Jersey or file a complaint with the Government Records Council ("GRC") by completing the Denial of Access Complaint Form. You may contact the GRC by toll-free telephone at 866-850-0511, by mail at PO Box 819, Trenton, NJ 08625, by e-mail at grc@dca.state.nj.us , or at their web site at www.state.nj.us/grc. The Council can also answer other questions about the law. All questions regarding complaints filed in Superior Court should be directed to the Court Clerk in your County.
Information provided on this form may be subject to disclosure under the Open Public Records Act.