STANDARD RIGHT-TO-KNOW REQUEST FORM

 

 

DATE REQUESTED:

 

REQUEST SUBMITTED BY:           U.S. MAIL        FAX     IN-PERSON  

           

 

NAME OF REQUESTOR (Optional):______________________________________

 

 

STREET ADDRESS (Optional):_____________________________________________

 

 

CITY/STATE/COUNTY (Required): __________________________________________

 

 

TELEPHONE (Optional):___________________________________________________

 

RECORDS REQUESTED:

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

 

 

 

 

 

 

 

DO YOU WANT COPIES?  YES or NO

 

DO YOU WANT TO INSPECT THE RECORDS?  YES or NO

 

DO YOU WANT CERTIFIED COPIES OF RECORDS? YES or NO

 

RIGHT TO KNOW OFFICER:

 

DATE RECEIVED BY THE AGENCY:

 

 

***Public bodies must fill anonymous verbal or written requests.  If the requestor wishes to pursue the relief and remedies provided for in this 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.)