Right to Know (if you would like to print out the form and mail it in you can download the form here.) Date of request* MM slash DD slash YYYY Request submitted to (Agency name & address)* Name of requester* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Records requested (please provide as much specific details as possible so the agency can identify the information.)Do you want copies? Yes No Do you want to inspect the records? Yes No Do you want certified copies of records? Yes No ** PLEASE NOTE: RETAIN A COPY OF THIS REQUEST FOR YOUR FILES (emailed to you)** ** IT IS A REQUIRED DOCUMENT IF YOU WOULD NEED TO FILE AN APPEAL ** Δ
