Date:
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
INFORMATION
REQUESTER'S NAME:
*
First Name
Last Name
ADDRESS:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
COMPANY:
*
CITY/STATE/ZIP:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
EMAIL:
*
example@example.com
PHONE NUMBER:
*
Format: (000) 000-0000.
RECORD'S REQUESTED:
Please describe the public records you are requesting as clearly and specifically as possible.
*
Preferred Format (check all that apply)
*
Paper Copies
Electronic Copies
Inspection of records in person
Delivery Method
*
Email
U.S. Mail
Pick up in person
FEES:
Please notify me if the estimated cost exceeds: $ (.25 per page. Cash ONLY or Check made out to the School City of East Chicago).
CERTIFICATION:
I certify that this request is made in accordance with the Indiana Access to Public Records Act (IC 5-14-3).
Date:
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature
*
Preview PDF
Submit
Back
Next
FOR DISTRICT USE ONLY:
Receivers Name:
First Name
Last Name
Response Due Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Fees Assessed:
Date Records Provided:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Request deemed & reason:
Total Pages:
Total Cost:
Date Stamp Receipt
Under Indiana's Access to Public Records Act, a public employer must respond to a public records request within 24 hours if made in person or by phone, or within seven calendar days if made in writing, by acknowledging receipt and advising when records will be provided. The Freedom of Information Act (FOIA) request can be denied for being burdensome. FOIA allows agencies to deny requests that are deemed "unduly burdensome" under certain conditions.
Email Address:
hr@scec.k12.in.us
Location:
4001 Indianapolis Blvd.
East Chicago, IN 46312
Phone Number:
219-391-4100
Should be Empty: