ELK TOWNSHIP

REQUEST FOR ACCESS TO PUBLIC RECORDS

REQUEST

Date of Request:

Name:

Mailing Address:

Phone Number:

Identify or describe the records sought with sufficient specificity to enable the Township to

ascertain which records are being sought:

ACKNOWLEDGEMENT OF TOWNSHIP

On behalf of Elk Township hereby acknowledges receipt

of the request for access to public records on ___ day of , 2008.

Township Representative