FOIA Request

This Freedom of Information Act request can be customized for requests of records by any individual, member of the media, or academic pursuits.

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This Printable Business Form Template belongs to these categories: request

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FREEDOM OF INFORMATION ACT REQUEST

Andy Anderson
123 Main St.
Anytown, CA 95928
(555) 555-1212
[email protected]

[Head of Agency]
[Agency]
[Address]
[City, State, ZIP]

Re: Freedom of Information Act Request

August 14, 2010

Dear ______________:

This request is being made under the Freedom of Information Act.

I hereby request that a copy of the documents [described below/containing the information described below] be provided to me:

In regard to the assessment of fees, I would like to let you know that this request is being made for noncommercial or scholarly uses and I am a [representative of the news media/affiliated with an educational institution/________]. Therefore, I request a waiver of all fees as providing this information is in the public interest as explained below:

[alternative text]: I am willing to pay fees of up to $______ for this request. If you expect fees to be assessed and exceed this amount, please let me know before filling the request.

Sincerely,

Jessica Jessup

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