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Right to Know Request Form

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Step One

STANDARD RIGHT-TO-KNOW REQUEST FORM
Housing and Redevelopment Authorities of the County of Butler
114 Woody Drive
Butler, PA 16001
DATE REQUESTED: _____________
RECORDS REQUESTED:
*Provide as much specific detail as possible so the agency can identify the information.
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Name
Email Address
Address
City
State
Zip Code
Phone Number
Fax Number
DO YOU WANT CERTIFIED COPIES OF RECORDS?
1. YES
2. NO
DO YOU WANT TO INSPECT THE RECORDS?
1. YES
2. NO
DO YOU WANT COPIES?
1. YES
2. NO
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