Skip to Content - Skip to Navigation

Right to Know Information Request Form

Date requested _______________________________________________________

 

Request submitted by:    E-mail      U.S. Mail      Fax     In Person

 

Name of requester: _____________________________________________________

 

Street address: ________________________________________________________

 

____________________________________________________________________

 

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:

Agency five (5)-day response due: 

 

 

**Public bodies may 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.)

  • Administration and Finance Division
  • Sutton Hall, Room 233
    1011 South Drive
    Indiana, PA 15705
  • Phone: 724-357-2202
  • Fax: 724-357-4057
  • Office Hours
  • Monday through Friday
  • 8:00 a.m. – 12:00 p.m.
  • 1:00 p.m. – 4:30 p.m.