|Bradford City Water Authority
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Date Requested: __________________
Request Submitted by:____ E-Mail ____ US Mail ____ Fax ____ In-Person
Name of Requestor (Optional): _____________________________________
Street Address (Optional): _________________________________________
City/State/County (Required): ______________________________________
Records Requested (Provide as much specific detail as possible so the agency can identify the information):
Do you want copies? Yes or No __________
Do you want to inspect Records? Yes or No __________
Do you want certified copies of Records? Yes or No __________
Open Records Officer: Kim Benjamin
Date Received by the Agency: _____ / _____ / _____
*** Public bodies must fill anonymous verbal or written requests.
If the requestor wishes to pursue the relief and remedies provided for in the 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).