I, , have made a request under the provisions of the Kentucky Open Records Act for the following information:
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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to the benefit of the following entity:
to the benefit of the following entity:
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.
WITNESS the certification of purpose of the party hereto by the signature affixed hereon.
My Commission expires: ___