POCONO TOWNSHIP POLICE DEPARTMENT
RIGHT TO KNOW INFORMATION REQUEST
Date of Request:_________________________
Name of Requester (Required):____________________________________
Mailing Address (Required):______________________________________
_____________________________________________________________
Telephone No. (Required):_________________ Fax:__________________
Email:_________________________________
Records Requested: In the space below, you must identify or describe the requested
records with sufficient information to enable this agency to identify which records are
being sought. If necessary, attach additional pages. There is a $0.25 per page fee for all
reports ($0.35 per page for color copies).
Production of requested public records is subject to pre-payment of all Right to Know
fees. For security purposes this agency will only produce public records in a paper
format, unless the records exclusively exist in another medium.
PLEASE SUBMIT YOUR REQUEST TO:
POCONO TOWNSHIP POLICE DEPARTMENT
110 TOWNSHIP DRIVE
TANNERSVILLE, PA 18372
PHONE: 570-629-7200 FAX: 570-629-1501
EMAIL: poconopd@ptd.net
THIS SECTION WILL BE COMPLETED BY THE POLICE DEPARTMENT.
Request Tracking No.:_______________ Date Received:__________________
Request Response Date:______________ Approved ____ Denied ____
Records Officer:_____________________
