Please use this revised sample RTK request letter for requests from the state-affiliated universities (Penn State, Pitt, Lincoln and Temple) beginning July 1, 2008 and for all other RTK requests beginning Jan. 1, 2009.

This form was created by the Pennsylvania Office of Open Records. It is available along with other RTKL information on the Office of Open Records website at http://openrecords.state.pa.us

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[Date]

STANDARD RIGHT-TO-KNOW REQUEST FORM

DATE REQUESTED:

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

NAME OF REQUESTOR :______________________________________

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.)