NOTE: In most cases, a completed RTKL request form is a public record. Form updatedNov.27, 2018 More information about the RTKL is available at https://www.openrecords.pa.gov Standard Right-to-Know Law Request Form Good communication is vital in the RTKL process. Complete this form thoroughly and retain a copy; it is required SUBMITTED TO AGENCY NAME: (Attn: AORO) Date of Request: Submitted via: Email U.S. Mail Fax In Person PERSON MAKING REQUEST: Name: Mailing Address: City: State: Zip: Email: Telephone: Fax: How do you prefer to be contacted if the agency has questions? Telephone Email U.S. MailRECORDS REQUESTED: Be clear and concise. Provide as much specific detail as possible, ideally including subject matter, time frame, and type of record or party names. Use additional sheets if necessary. RTKL requests should seek records, not ask questions. Requesters are not required to explain why the records are sought or the intended use of the records unless otherwise required by law. DO YOU WANT COPIES? Yes, electronic copies preferred if availableYes, printed copies preferredNo, in-person inspection of records preferred (? Yes (may be subject to additional costs) No RTKL requests may require payment or prepayment of fees. See the Official RTKL Fee Schedule for more details. Please notify me if fees associated with this request will be more than $100 (or) $.Tracking: Date Received: Response Due (5 bus. days): 30-Day Ext.? Yes No (If Yes, Final Due Date: ) Actual Response Date: Request was: Granted Partially Granted & Denied Appropriate third parties notified and given an opportunity to object to the release of requested records. American LegalNet, Inc. www.FormsWorkFlow.com