Right-to-Know Request Form

Date Request Submitted:

Date

Full Name*

First NameLast Name

Company Name (if applicable)

Please send response via:*

E-MailMailFax

Email*

example@example.com

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Area CodePhone Number

Fax Number

Area CodePhone Number

How do you prefer to be contacted if the agency has questions?*

TelephoneE-MailFax

By checking this box, I affirm that my full name and contact information is true and correct, and that I am a legal resident of the United States. I understand that failure to check this box may result in the denial of my request and the dismissal of any appeal filed with the Office of Open Records.

RECORDS REQUESTED: Provide as much detail as possible, including subject matter, time frame, and type of record sought. RTKL requests must seek records, not ask questions. Use additional pages if necessary.

Records Requested:*

Provide as much specific detail as possible so the Township can identify the records

Records Requested

Browse Files

Do you want copies*

Yes (printed)Yes (electronic)No (in-person inspection)

Records shall be provided in the medium requested if they exist in that medium; otherwise, they shall be provided in the medium in which they exist. See Section 701. Your request may require payment or prepayment of fees.

I understand that my request may incur fees. Notify me before further processing if fees will be more than

$100

Do you want Certified Copies of the Record(s). Additional fees apply.*

Yes (will be subject to additional costs)No

Anonymous verbal or written requests will not be accepted. 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). You will receive an email confirmation within 72 hours of your request if you have provided your email address. Fees apply for paper copies per the Amity Township fee schedule. Questions may be directed to our Right-to-Know Officer at (610) 953-0017.