Freedom of Information Act Request

Note to Requester: Retain a copy of this request for your files. If you eventually need to file a Request for Review with the Public Access Counselor, you will need to submit a copy of your FOIA request.

Name and Address of Public Body Receiving Request

Name of Requester(Required)

First Last

Address of Requester(Required)

Street Address Address Line 2 City State ZIP Code

Phone

Fax

Records Requested(Required)

Provide as much specific detail as possible so the public body can identify the information that you are seeking.

Do you want copies of the documents?

Yes

Do you want electronic copies or paper copies?

Electronic copies

Paper copies

What format of electronic copy?

Is this request for a commercial purpose?

It is a violation of the Freedom of Information Act for a person to knowingly obtain a public record for a commercial purpose without disclosing that it is for a commercial purpose, if requested to do so by the public body. 5 ILCS 140.3.1(c)

Yes

Are you requesting a fee waiver?

If you are requesting that the public body waive any fees for copying the documents, you must attach a statement of the purpose of the request, and whether the principal purpose of the request is to access or disseminate information regarding the health, safety, and welfare or legal rights of the general public. 5 ILCS 140/6(c)

Yes

Purpose of the Request

Required if you are requesting a fee waiver; otherwise, not required.

Accepted file types: doc, docx, pdf, Max. file size: 2 GB.

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