FREEDOM OF INFORMATION ACT REQUEST FOR PUBLIC RECORDS

 

This form is made available for the convenience of making Freedom of Information Act "FOIA" requests. You are not required to utilize this form, unless your request is for commercial purpose. All FOIA requests for commercial purposes must be submitted on this form (see below). All FOIA requests must be in writing, but may be submitted either by personal delivery, U.S. Mail to 120 E Oak St., Addison, IL 60101, by facsimile to 630.833.6025, or e-mail to FOIA@addisonparks.org (items in gray below are for FOIA Office use only)

FOIA Request
 

FROM:

       
Name: *
Last

First
   
           
  Address: *
Street

City

State

Zip
           
  Phone Contact: *
(xxx) xxx-xxxx
Email Address: *
           
DESCRIPTION /TITLES OF REQUESTED RECORD(S): *
         
  Check all of the following that are applicable: *  
           
  I wish only to inspection these records at the office of the Freedom of Information Officer. I understand that inspection is available only during business hours Monday through Friday, except legal holidays, from 9:00 a.m. to 5 p.m.
           
  I request copies these documents in the following format, if available, and agree to pay the charges as indicated. If requested format is not available, you will be contacted to select another:
           
  Format:    
 

8 ½" x 11", or legal, black & white, on white paper

First 50 pages are free; $.15 per page above 50.
Actual cost of reproduction.
$.[__] per disk.
$ [__] per tape.
Actual cost of medium.
  Other color print or paper stock
  CD ROM  
  Micro - cassette tape  
  Other electronic    
       
  Delivery
Method:
   
  I request that copies be sent via U.S. Mail   $ [__] actual cost of postage
  I request that the material be e - mailed, if available.    
         
  REQUESTS FOR COMMERCIAL PURPOSE It is mandatory to identify if this is a commercial request); A request is considered "for a commercial purpose" if all or any part of the information will be used in any form for sale, resale, solicitation or advertisement for sales or services. Failure to disclose whether a request is for a comme rcial purpose is a prosecutable violation of FOIA.
         
    I understand that any payment need be received before documents are copied and/or mailed.

 

           

***For FOIA Office Use Only***

 
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Date Request
Received
Date Response
Due
Date Extended
Response Due
Total Cost
Date Documents
Provided/Inspected