|
|
Public Records Request Form
|
|
|
|
|
|
|
|
Full Name
|
|
|
|
|
|
|
|
Street Address*
|
|
|
|
|
|
|
|
P.O. Box
|
|
|
|
City, ST*
|
|
|
|
|
|
|
|
|
|
|
|
|
Zip Code*
|
|
|
|
Phone Number
|
|
|
|
|
|
|
|
|
It is the intent of the Township to comply in all respects with the Pennsylvania Right to Know Law. In order to process a request for inspection and/or duplication of a public record, the Township needs sufficient and specific information to identify the record. The Township may deny a request if there is inadequate information for the Township to identify the specific record requested. Please provide as much of the following requested information as possible:
|
|
|
|
Type of document (e.g. ordinance, resolution, meeting minutes, etc.):
|
|
|
|
|
|
|
|
Subject of document (e.g. sewage system ordinance, building permit for a specifically identified property, Zoning Hearing Board decision, etc.):
|
|
|
|
|
|
|
|
Approximate date or dates of documents (give date range):
|
|
|
|
|
|
|
|
Please state any other information which you believe would assist the Township in identifying the public record which you seek:
|
|
|
|
|
|
|
|
I wish to examine this public record at the Township office:
|
|
|
|
Yes
|
|
|
|
|
|
|
|
|
|
|
No
|
|
|
|
|
|
I wish to obtain a copy of this public record (fees apply):
|
|
|
|
Yes
|
|
|
|
|
|
|
|
No
|
|
|
|
|
|
Unless otherwise requested, the Township will provide paper photocopies of public records. The Township does not guarantee a requested record is available or can be made available in any other format.
|
|
|
|
I wish a copy of the public record be provided as follows, if possible:
|
|
|
|
|
|
|
|
If "Email" was selected, please provide Email address:
|
|
|
|
|
|
|
|
If "Facsimile" was selected, please provide fax phone number:
|
|
|
|
|
|
|
|
I wish the Township to mail a copy of this public record to me:
|
|
|
|
Yes
|
|
|
|
|
|
|
|
No
|
|
|
|
|
|
I wish the public record to be mailed to the following address:
|
|
|
|
|
|
|
|
PLEASE READ BEFORE HITTING "SUBMIT"
|
|
|
|
I acknowledge that the Township will charge a fee to recover its cost incurred in the review of the files, the duplication of public records, and the mailing of public records. I acknowledge that the Township does not have to provide me with the copies (if any) I have requested until I pay the fee in full.
|
|
|
|
|
|
|