Right To Know Request Form - Lawrence County printable pdf download

Right To Know Request Form - Lawrence County

LAWRENCE COUNTY

PENNSYLVANIA

430 Court Street, New Castle, PA 16101

724-658-2541

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RIGHT-TO-KNOW REQUEST FORM

DATE REQUESTED: ____________________________

E-MAIL

U.S. MAIL

FAX

IN-PERSON

REQUEST SUBMITTED BY:

NAME OF REQUESTOR: ______________________________________

STREET ADDRESS: (required) _____________________________________________

CITY/STATE/COUNTY: (required) __________________________________________

TELEPHONE: (optional) ___________________________________________________

RECORDS REQUESTED:

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

YES

DO YOU WANT COPIES?

YES

DO YOU WANT TO INSPECT THE RECORDS?

YES

DO YOU WANT CERTIFIED COPIES OF RECORDS?

____________________________________________________________________________

FOR OFFICIAL USE ONLY

RIGHT TO KNOW OFFICER: _________________________________________

DATE RECEIVED BY THE AGENCY: __________________________________

AGENCY FIVE (5)-DAY RESPONSE DUE: ______________________________

**The County may fill anonymous verbal or written requests. If the requestor wishes to pursue

the relief and remedies provided for in the Act, the request must be in writing. (Section 702.)

Written requests need not include an explanation why information is sought or the intended use

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

Submit

Right To Know Request Form - Lawrence County