(Revised 6-22-2018)
Office of Open Records
Date Requested:
Request Submitted By (check): E-mail U.S. Mail Fax In-Person
Name of Requester:
Requester’s Address:
City/State/County/ZIP Code:
Telephone (optional):
Records Requested:
*Provide as much specific detail as possible so the agency can identify the information sought. When possible, describe
the range of documents, timeline and, if applicable, the event location if different from requester’s address. For police
reports, identify the county where the incident occurred. For law enforcement audio and/or video recordings, include
the specific date and time of event, requester’s relationship to event and, if inside a residence, the identity of all persons
present, if known.
Do you want an emailed response? Email address:
Do you want copies? (check)
Do you want to inspect the records? (check) YES or NO
Do you want certified copies of records? (check) YES or NO
For internal use
Right to Know Officer:
Tad J. Miller, Solicitor’s Office, 10 East Church Street, Bethlehem, PA 18018.
Tel: (610) 865-7011; Fax: (610) 865-7205;
Date received by the agency:
Agency five (5)-day response due:
**Public bodies may fill anonymous verbal or written requests. If the requester 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.)
*Requests for Police audio
and/or video must be received
within 60 days of the recorded
event, as per 42 PaCS
* The Police have an automatic
30-day period of time to
provide law enforcement audio
and/or video recordings, as per
42 PaCS § 67A05(a).
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