Service Request Form

Borough of Edinboro

SERVICE REQUEST FORM

Please use this form to request services. This form should be printed, then forwarded to the Borough of Edinboro at 124 Meadville Street, Edinboro, PA 16412 or emailed to edinboro@edinboro.net. All responses will be returned to the applicant. Highlight the form with your mouse, then print selection.

TOPIC:

DATE:

STATEMENT:

CITIZEN’S NAME:

PHONE #:

ADDRESS:

OFFICIAL USE:
REFERRED TO:			DATE:
ACTION TAKEN:



				COUNCIL ð
FILE INFORMATION:	COMPLETED ð	SOLVED ð	REFERRED ð	NEXT BUDGET ð
OTHER ACTION:				DATE:

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Borough of Edinboro
RECORD REQUEST FORM

Please use this form to request records. This form should be printed, then forwarded to the Borough of Edinboro at 124 Meadville Street, Edinboro, PA 16412 or emailed to edinboro@edinboro.net. All responses will be returned to the applicant. Highlight the form with your mouse, then print selection.

HOME RULE BOROUGH OF EDINBORO
RECORD REQUEST FORM
To:    Borough Manager or Assistant to the Manager
         The Borough of Edinboro
         124 Meadville Street
         Edinboro, PA 16412
Date:_______________________________________________________________________________
Your Name:__________________________________________________________________________
Your Address:________________________________________________________________________
___________________________________________________________________________________
Phone Number:_________________________             Fax Number:______________________________
Specific Description of Records you would like to examine, inspect, and/or have copied ( for more space, continue on back)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
ٱ     I will pick up the public records on ____________________________________________________
ٱ     Please mail the public records to me at__________________________________________________
      ________________________________________________________________________________
ٱ     Please fax the public records to me at___________________________________________________
YOUR SIGNATURE__________________________________________________________________
____________________________________________________________________________________
For Office Use Only:
Date Request Received______________________
Fees:             Copies $_____            Postage $______             Disk $_____           Fax $_____
Total Cost $_________
Date Request Fulfilled______________
Date Information: Picked up______________   Faxed_______________   Mailed________________

________________________________________________________
Borough of Edinboro Manager/Assistant to the Manager

Click Here to Download the Service Request Form

E-mail general questions or comments to edinboro@edinboro.net
E-mail questions or comments about the site to mlander@edinboro.net