2. 
5. Public Records Request
7. To: Open Records Officer
10. From:
12. Name*
14. Address*
16. City*
17. State*
18. Zip Code*
20. Phone Number*
21. Fax Number
23. Email Address
25. Note that you must identify or describe the requested records with sufficient specificity to allow the Township to determine what records are being requested. Attach additional sheets if necessary. You may deliver this to the township office in person, by mail, email, or fax it to (215) 659-1603.
27. I hereby request copies of the following records:*
29. I would like to:*

    1. Review
    2. Receive
31. Signature of Requestor
33. First Name*
34. Last Name*
35. Date:*
    Date:
40. FOR OFFICIAL USE ONLY
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

* indicates a required field