Standard Right-To-Know Request Form - Borough Of Chambersburg printable pdf download

Standard Right-To-Know Request Form - Borough Of Chambersburg

Borough of Chambersburg

A full service municipality in Franklin County

celebrating over 65 years of consumer owned natural gas service

over 100 years of community electric and a

regional wastewater, water, and municipal solid waste utility

PENNSYLVANIA

OFFICE OF OPEN RECORDS

STANDARD RIGHT-TO-KNOW REQUEST FORM

DATE REQUESTED: _____________________________

REQUEST SUBMITTED BY:

E-MAIL U.S. MAIL

FAX

IN-PERSON

NAME OF REQUESTOR: ______________________________________

REQUESTOR STREET ADDRESS (Required): ____________________________________

REQUESTOR CITY/STATE/COUNTY (Required): ___________________________________

TELEPHONE _______________________ EMAIL: __________________________________

RECORDS REQUESTED:

*Provide as much specific detail as possible so the agency can identify the information. Please

use additional sheets if necessary.

DO YOU WANT COPIES? YES or NO

DO YOU WANT TO INSPECT THE RECORDS? YES or NO

DO YOU WANT CERTIFIED COPIES OF RECORDS? (Fees may apply) YES or NO

**Please Note: Retain a copy of this request for your files**

**It is a required document if you would need to file an appeal**

____________________________________________________________________________

RIGHT TO KNOW OFFICER:

DATE RECEIVED BY THE AGENCY:

AGENCY FIVE (5)-DAY RESPONSE DUE:

**Public bodies may fill anonymous verbal or written requests. If the requestor wishes to pursue the relief and remedies provided for this Act,

the request must be in writing. (Section 702.) Written request need not include an explanation why information is sought or the intended use

of the information unless otherwise required by law. (Section 703.)

100 S. 2

Street, Chambersburg, Pennsylvania 17201-2512



Telephone (717) 264-5151

Fax (717) 264-0224

Standard Right-To-Know Request Form - Borough Of Chambersburg