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Fax:

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 Towns hip requires 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*:

Document Subject*:

Approximate date of documents(should be within a 3-6 month time frame)*:

State any other information which you believe would assist the Township in identifying the public record you seek:

I wish to examine this public record at the Township office:

YesNo

I wish to obtain a copy of this public record:

YesNo

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 the public record in the following format or media:

I wish the Township to mail a copy of the public record to me: YesNo

I wish the record to be mailed to:

I acknowledge that the Township will charge a fee to recover its costs incurred in the review of 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.

I accept these terms.

Date*: