THE BOROUGH OF RIDGWAY




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STANDARD RIGHT-TO-KNOW REQUEST FORM



DATE REQUESTED: _________________



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


 

REQUEST SUBMITTED TO (Agency name & address):__________________________________________


 

________________________________________________________________________________________


           

NAME OF REQUESTER: __________________________________________________________________


 

STREET ADDRESS:_______________________________________________________________________



CITY/STATE/COUNTY/ZIP(Required): ________________________________________________________


 

TELEPHONE (Optional):_____________________    EMAIL (optional):_____________________________


 

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


Please use additional sheets if necessary


 


  


DO YOU WANT COPIES?  YES   NO


DO YOU WANT TO INSPECT THE RECORDS?  YES  NO


DO YOU WANT CERTIFIED COPIES OF RECORDS? YES NO


DO YOU WANT TO BE NOTIFIED IN ADVANCE IF THE COST EXCEEDS $100? YES NO


 


** PLEASE NOTE: RETAIN A COPY OF THIS REQUEST FOR YOUR FILES **


** IT IS A REQUIRED DOCUMENT IF YOU WOULD NEED TO FILE AN APPEAL **


____________________________________________________________________________


FOR AGENCY USE ONLY


 

OPEN-RECORDS OFFICER: Paul J. McCurdy, Borough Manager


   I have provided notice to appropriate third parties and given them an opportunity to object to this request


 


DATE RECEIVED BY THE AGENCY:


 


AGENCY FIVE (5) BUSINESS 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.)