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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.)

  • Human Resources Office
  • Sutton Hall, Room G8
    1011 South Drive
    Indiana, PA 15705
  • Phone: 724-357-2431
  • Fax: 724-357-2685
  • Office Hours
  • Monday through Friday
  • 8:00 a.m.–4:30 p.m.