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doc16217 Commerical_Purpose_Certification.pdf

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Page 1

19 item(s) JSON
figure (2) form_field (3) heading (1) text (12) title (1)
Page 1
1 · TITLE
2 · TEXT
3 · TEXT
4 · FIGURE
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6
7
8 · TEXT
9 · TEXT
10 · FIGURE
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12
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18 · TEXT
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Page 1 JSON
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            "text": "CERTIFICATION OF COMMERCIAL PURPOSE\nFOR OPEN RECORDS REQUEST",
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            "text": "I, , have made a request under the provisions of the Kentucky Open Records Act for the following information:"
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            "text": "I attest that this information is to be used for the following commercial purpose (as defined in KRS 61.870 (4)(a)):"
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                    "text": "to the benefit of the following entity:"
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            "text": "I understand that I may be required to enter into a contract with Kentucky State University, through any of its agencies, in order to obtain this information, which may be provided for the stated commercial purpose for a specified fee. I further understand that, in accordance with K.R.S. 61.874(5), it is unlawful to obtain a copy of any part of a public record for a commercial purpose, if I use or knowingly allow the use of the public record for a use other than that for which I submit this certification, or resell the information to a third party."
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            "text": "WITNESS the certification of purpose of the party hereto by the signature affixed hereon."
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                "embedded_text": "STATE AT LARGE, ___________________"
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                    "text": "By: ___"
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                    "text": "The foregoing document was acknowledged before me this day of,20, to be the true act and deed of said individual and/or entity."
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                    "text": "NOTARY PUBLIC\nSTATE AT LARGE,",
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