2. Date Requested
   Date Requested
4. Request Submitted by:

   1. E-Mail
   2. U.S. Mail
   3. Fax
   4. In-Person
6. SUBMITTED TO AGENCY NAME: *

   (Attn: AORO)

8. PERSON MAKING REQUEST:*

   Full Name

10. Company (if applicable):

12. Please send response via:

    1. Email
    2. U.S. Mail

14. If you wish to obtain records that only exist in hard copy, or must be provided on an electronic storage device, you may be required to provide a mailing address to the agency. See Section 703.

16. Email*
18. Mailing Address: *
20. City
21. State
22. Zip Code
24. Telephone*
26. How do you prefer to be contacted if the agency has questions?

    1. Telephone
    2. Email
    3. U.S. Mail
28. Confirmation *

    1. 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.
30. 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.

32. DO YOU WANT COPIES?

    1. Yes, printed
    2. Yes, electronic
    3. No, in-person inspection

34. 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. View the Official RTKL Fee Schedule for more details.

36. Do You Want to Inspect the Records?

    1. Yes
    2. No
38. Do You Want Certified Copies of Records?

    1. Yes (may be subject to additional costs)
    2. No
40. Additional Fees

    I understand that my request may incur fees. Notify me before further processing if fees will be more than $100. 

    1. Yes
    2. No
42. ** Please Note: Retain a Copy of This Request for Your Files **
44. ** it is a Required Document if You Would Need to File an Appeal **
48. **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.)
Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit

* indicates a required field