Request Direct Interest Participant Status

Direct interest participant - A person or entity, other than the requester or agency, who has been granted the ability to participate before the OOR under § 77.75 (relating to request for direct interest participant status).

Please accept this as a Request to Participate in a currently pending appeal before the Office of Open Records. The statements made herein and in any attachments are true and correct to the best of my knowledge, information and belief. I understand this statement is made subject to the penalties of 18 Pa.C.S. § 4904, relating to unsworn falsifications to authorities.

Docket #:

Name:

Type:

PUBLIC RECORD NOTICE

All filings with the OOR will be public records and subject to public access with limited exception. If you do not want to include personal contact information in a publicly accessible record, please provide alternate contact information in order to receive future correspondence related to this appeal.

Do not include private information such as Social Security Numbers.

Address:

Email:

Phone #:

Comments:

Attach Files:

Maximum file attachments: 10
Maximum file size: 25MB per attachment
Allowed file types: pdf, doc, docx, rtf, txt, xls, xlsx, ppt, pptx, jpg, png, gif, bmp, tiff
Allowed Characters: a-z A-Z 0-9 ( ) . , & _ -

I have a direct interest in the record(s) at issue as (check all that apply):

The owner of a record containing confidential or proprietary information or trademarked records
An employee of the agency
A contractor or vendor

I have attached a copy of all evidence and arguments I wish to submit in support of my position.

Printable version of this form (revised May 2023):