Application For Access To Public Records Form

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ERIE COUNTY, NY
Freedom of Information Law
Application For Access to Public Records
Instructions: Complete all areas of this form and return to the “FOIL” Records Access Officer for the
Erie County Department that maintains the records you seek.
***To request information maintained by an independent office within Erie County Government (i.e.,
Board of Elections, Clerk, Comptroller, District Attorney, Legislature, and Sheriff) you must contact that
office directly on how to submit a FOIL request.***
After receiving your request, Erie County is permitted five (5) business days to respond to your request.
In accordance to §§87 (b) (iii) and 87(c) (i-iii), a charge of $0.25 per page copied as well as other charges
associated with the cost of reproducing a record may be applicable.
TO:
FOIL Records Officer
DATE: _____________________
Erie County Department of ________________________
I hereby apply to [
] inspect or obtain [
] a hard copy [
] an electronic copy of the following
records under the provisions of the Freedom of Information Law (please include as much detail about the
records as you can, including relevant dates, names, descriptions, ect): ____________________________
Signature: _______________________________ Printed Name: ________________________________
Organization (if applicable): _____________________________________________________________
Address: _________________________________ City: ______________ State: _____ Zip: _________
Email: ____________________________________________ Telephone: ________________________
………………………………………………………………………………………………………………..
FOR AGENCY USE ONLY
[
] Approved
Name:____________________________________ Date: _______________
Denied (for the following reasons)
] Confidential disclosure
[
] Part of investigatory files
[
[
] Unwarranted invasion of personal privacy
] Record of which this agency is legal custodian cannot be found
[
] Record is not maintained by this agency
[
[
] Excepted by statute other than the Freedom of Information Law
] Other/Comments:__________________________________________________________________
[

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