Wayne County Office of Open Records
Andrew Seder, Public Information Officer
Wayne County Commissioners' Office
925 Court Street, Honesdale PA 18431
Phone: 570-253-5432 ext. 4050
Email: openrecords@waynecountypa.gov

* Good communication is vital in the Right-to-Know Law (RTKL) process. Complete this form thoroughly and retain a copy; it is required should an appeal be necessary. You have 15 business days to appeal after a request is denied or deemed denied.

Submitted to agency name:*

Date of Request:*

Request Submitted via:*

E-mail US Mail Fax

In person Online

Person Making Request:

Name:

Company (if applicable):

Street Address:*

City, State & County*

Email address:

Telephone:*

Fax:

RECORDS REQUEST:

* Be clear and concise. Provide as much specific detail as possible, ideally including subject matter, time frame, and type of record or party names. Use additional sheets if necessary. RTKL requests should seek records, not ask questions. Requesters are not required to explain why the records are sought or the intended use of the records unless otherwise required by law.

Records requested:*

Do you want copies?*

Yes, electronic copies if available Yes, printed copies preferred

No, in-person inspection of records preferred (may request copies later)

Do you want certified copies?*

Yes (may be additional cost)

No

Do you want certified copies of the records?*

Yes

No

* Right-to-Know Law requests may require payment or prepayment of fees.

Official RTKL Fee Schedule

Please notify me if fees associated with this request will be more than:*

$100

Other

Enter other amount:

Items Below This Line for Agency Use Only

Tracking:

Date Received:

Response Due (5 bus. days)

30-Day Ext?

Yes

No

If Yes, final due date:

Actual Response Date:

Request was:

Granted Partially Granted & Denied

Denied

Cost to requestor:

Appropriate third parties notified and given an opportunity to object to the release of requested records.

Yes

No

NOTE: In most cases, a completed RTKL request form is a public record.

More information about the Pennsylvania Right-to-Know Law:

PA Office of Open Records