Right to Know Request Form

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Name of Requestor

Street Address *

City *

State

Zip *

Telephone (optional)

Fax (optional)

Email *

How do you prefer to be contacted if the agency has questions? *

Telephone

U.S. Mail

Records Requested *

Be clear and concise. Provide as much specific detail as possible, ideally including subject matter, time frame, and type of record or party names. RTKL requests should seek records, not ask questions. Requesters are not required to explain why the records are sought or the intended use of the records unless otherwise required by law.

Do you want copies? *

Yes, electronic copies preferred if available

Yes, printed copies preferred

No, in-person inspection of records preferred (may request copies later)

Do you want certified copies?

Yes (may be subject to additional costs)

Notify me if fees associated with this request will be more than ($USD):

NOTE:

Please be advised that the requested record(s) will be provided in the format which the Agency maintains it (them). RTKL requests may require payment or prepayment of fees. See the Official RTKL Fee Schedule for more details.

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