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    HOLLIDAYSBURG AREA SCHOOL DISTRICT

     

    STANDARD RIGHT-TO-KNOW REQUEST FORM

     

     

    DATE REQUESTED ________________________________

     

    REQUEST SUBMITTED BY:    __ E-MAIL    __U.S. MAIL    __ FAX    __IN PERSON

     

     

    NAME OF REQUESTER ___________________________________________________

     

    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            __NO

     

    DO YOU WANT TO INSPECT THE RECORDS?    __YES             __NO

     

    DO YOU WANT CERTIFIED COPIES OF RECORDS?      __YES             __NO

     

     

     

    OPEN RECORDS 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.)