Fillable Police Right To Know Request

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Police Right To Know Request

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The Police Right To Know Request form is 1 page long and contains:

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Country of origin: OTHERS
File type: PDF

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Date Requested:
Submitted via: Walk-in US Mail Email Fax
Name of Requester:
Tele:
Address:
Email:
City/St/Zip:
Fax:
Records Requested: (Provide as much detail as possible so the agency can identify the information. (Use back if necessary.)
Do you want copies?
Yes
No
Do you want certified copies?
Yes
No
Do you want to inspect records?
Yes
No
SUBMIT TO: Lt. Stephen Homoki (Police Records)
48 N. 4
th
Street
Easton, PA 18042
OFFICE 610-250-6664 FAX 610-250-6619
Rita Messa (General Gov’t Records)
123 S. 3
rd
Street
Easton, PA 18042
OFFICE 610-250-6730 FAX 610-250-6736
rmessa@easton-pa.gov
s
homoki@easton-pa.gov
***FOR OFFICIAL USE ONLY***
Request Received By:
Date Rec’d:
5day Response Date:
Request Approved By:
Date:
Dept: Records Traffic CID
Request Denied By:
Date:
Denial Letter. Sent:
Req. Partially App/Denied:
Date:
30 Day Ext. Due Date:
*Please note: You must retain a copy of this request form for your files. It is a required document if you would need to file an appeal.
I hereby acknowledge receipt of all information requested. I also acknowledge receipt of a copy of this
Right-to-Know request form for my records.
Print Name:
Signature:
02252019/lrt
CITY OF EASTON
RIGHT-TO-KNOW REQUEST FORM
REQUEST NO.
(FOR OFFICIAL USE ONLY)
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Police Right To Know Request

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Completed 22 January 2021

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