Request Form

Request for Access or Copy of Public Records

Date of Request:

Director, Roanoke Public Library

314 North Main Street Suite 120

PO Box 249

Roanoke, IN 46783-0249

Dear Director:

Pursuant to the Indiana Access to Public Records Act (IC  5-14-3), I would like to _____________________ (inspect or a copy of) the following records: (Be sure to describe the records sought with enough detail for the Library to be able to respond.) ______________________________________________________________

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I understand that if I seek a copy of this record, there may be a copying fee.  Please inform me of that cost prior to making the copy.  I can be reached at (phone number)____________________________.

According to the statute, you have ____ days to respond to this request.  (If this letter is delivered personally to the Library, they have 24 hours to respond to the request.  If this letter is delivered by U.S. Mail or by facsimile, the Library has seven days to respond to the request.)  If you choose to deny the request, then you are permitted to respond in writing and state the statutory exception authorizing the withholding of all or part of the public record and the name and title or position of the person responsible for the denial.

Thank you for your assistance on this matter.

Respectfully,

 

(Name and signature of person making this request)