CLARION-LIMESTONE AREA SCHOOL DISTRICT

4091 C-L SCHOOL ROAD

STRATTANVILLE, PA   16258

Phone - (814)764-5111

Fax – (814)764-5729

 

 

STANDARD RIGHT-TO-KNOW REQUEST FORM

 

 

DATE REQUESTED:

 

REQUEST SUBMITTED BY: ___E-MAIL___U.S. MAIL___ FAX___IN-PERSON  

           

 

NAME OF REQUESTOR :______________________________________

 

 

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 or NO

 

DO YOU WANT TO INSPECT THE RECORDS?  YES or NO

 

DO YOU WANT CERTIFIED COPIES OF RECORDS? YES or NO

____________________________________________________________________________

 

RIGHT TO KNOW 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.)