TO: Records Custodian, Cabinet for Health and Family Services / DCBS
[Verify the current official custodian and designated request address]
RE: Kentucky Open Records Act (KRS 61.870–61.884) request

Dear Records Custodian:

Pursuant to the Kentucky Open Records Act, I request copies of these existing, nonexempt records maintained by your agency:

1. Administrative directives, written policy exceptions, and supervisor tracking records concerning [defined topic or case-management parameter], applicable to offices serving Rowan, Montgomery, Menifee, and Bath counties, dated [start date] through [end date].
2. Written communications, internal guidelines, and manuals distributed to caseworkers during that period regarding changes to [identify the relevant provision of 922 KAR Chapter 1 or the specific compliance topic].

This request concerns nonexempt policy and administrative records, not confidential individual child-welfare case files.

I am a Kentucky resident because [accurate basis under KRS 61.870(10)]. The intended use of these records is [accurate description; identify commercial use if applicable].

For noncommercial use, please provide copies in a standard electronic format where maintained electronically, pursuant to KRS 61.874(2), preferably by email or download link. Please advise of fees exceeding $[limit] before incurring them.

Please release reasonably segregable nonexempt portions. If any part is withheld, identify the specific statutory exception and explain how it applies, as required by KRS 61.880(1).

Sincerely,
[Real printed name]
[Signature or electronic signature]
[Contact email]
[Date]