Requesting access or copy of a public record
Public Official or Agency
City, Indiana Zip Code
Dear Public Official:
Pursuant to the Access to Public Records Act (Ind. Code 5-14-3), I would like to (inspect or
obtain a copy of) the following public records:
(Be sure to describe the records sought with enough detail, or as the statute indicates, with
“reasonable particularity” for the public agency to understand the request and be able to
I understand if I seek a copy of this record, there may be a copying fee. Could you please inform
me of that cost prior to making the copy? I can be reached at (phone number and/or email
address. If you do not provide a phone number, fax number or email address, the agency will
likely mail the response to you by regular mail).
According to the statute, you have ____ days/hours to respond to this request. (If this letter was
delivered personally to the public official’s office, the agency has 24 hours to respond to the
request. If the letter is delivered by U.S. Mail, email or facsimile, the agency has seven days to
respond to the request.) If you choose to deny the request, you are required to respond in writing
and state the statutory exception authorizing the withholding of all or part of the public record and
the name and title or position of the person responsible for the denial.
Thank you for your assistance on this matter.