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9. Standard Act 22 Request Form (Police Audio and Video): CERTIFIED MAIL OR IN-PERSON ONLY

  1. Standard Act 22 Request Form (Police Audio and Video) 

  2. IMPORTANT: PLEASE NOTE

    This form cannot be submitted online. Please PRINT THIS PAGE and handwrite your answers in. Then, please submit via mail or in person to the Patton Township Police Department. Thank you. 

  3. *Written request must be made within sixty (60) days of the date of the recording

  4. Request Submitted By
  5. Request to be Submitted to:

    Patton Township Police Department
    Open Records Officer Tyler Jolley
    100 Patton Plaza, State College, PA 16803 

  6. Records Requested

    *Provide as much specific detail as possible so the agency can identify the information requested

  7. *If the requested incident took place inside a residence, every person present at the time of the recording must be identified, unless unknown and not reasonably ascertainable. 
    (Attach Statement if more space is required) 

  8. (Attach statement if more space is required) 

  9. **PLEASE NOTE: RETAIN A COPY of this request for your files**

    **It is a required document if you would need to file an appeal**

  10. For Agency Use Only

  11. Leave This Blank: