RECORD REQUEST FORM

							                                  971 N Colebrook Road
                                   Manheim Pa 17545


Rapho Township Request Form: (for copies of records)
Send or deliver to:
Township Manager, Rapho Township        971 N Colebrook Road        Manheim       PA   17545

Date of Request: _____________________________________

Requestor information:
Name:______________________________________________
Address:_____________________________________________
City Zip _____________________________PA________________
Phone: ________________________________________________

Record(s) request: [Document name of specific minute, order, decision, account, voucher or
contract requested: Date or approximate date of the above - please provide as specific
information as possible]
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How do you want the duplication forwarded to you? Mail _____ Fax ______ Special Mail
______
Name and address to whom duplication record should be provided if different from above.
Name:___________________________________________________
Address:_________________________________________________
City, Zip__________________________PA _______________________
If by Fax, please include fax number: _____________________________

Name, signature and date of person requesting record information:

Name (please print)                         signature                                    date

Rapho Township will respond to this request form within five (5) business days.




Phone 717-665-3827                         Email lori@raphotownship.com
Fax 717-665-7685
              nancy@raphotownship.com
darlene@raphotownship.com