Freedom Of Information Records Request Form - Village Of Algonquin
Download a blank fillable Freedom Of Information Records Request Form - Village Of Algonquin in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Freedom Of Information Records Request Form - Village Of Algonquin with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2.
PRESS HERE TO SUBMIT REQUEST
Date Received: ___________________________
(For office use only)
FREEDOM OF INFORMATION RECORDS REQUEST FORM
PLEASE COMPLETE THE REQUEST PART OF THIS FORM AND RETURN TO:
DEPUTY VILLAGE CLERK
VILLAGE OF ALGONQUIN
2200 HARNISH DRIVE
ALGONQUIN, IL 60102
Fax: (847) 658-4564
email:
CONTACT INFORMATION:
(please print clearly)
Name : ______________________________________________________________________________
Company Name: ______________________________________________________________________
Address: ____________________________________________________________________________
City, State Zip: ________________________________________________________________________
Email address: ________________________________________________________________________
Phone: (______) ______________________________ Fax (______) ____________________________
DETAILED DESCRIPTION OF RECORD(S) REQUESTED:
Please note if waiver of fees is being requested and justification.
Y
N
Will the records disclosed in the this request be used for commercial purposes?
It is in violation of this Act to knowingly obtain records for commercial purposes without disclosing your intent.
INSPECT RECORDS?
COPY OF RECORDS
CERTIFIED
Y
N
Y
N
Y
N
NOTE:
There will be a copy charge of 10 cents per black & white page after 50 pages per requestor and color pages 18 cents (not to exceed 11X17) . Pages larger
than 11X17 (i.e. Plans, Plats, etc.) will be charged $3.00 per page , certification $1.00 per document, CD $2.00 per CD.
Unless a waiver of fees is requested and approved, I agree to pay all applicable fees as stated above. By submitting this request, I acknowledge and represent that I
have reviewed and understood the Freedom of Information Act guidelines and that all information provided in support of this request is true and accurate.
Please complete the following upon receipt of document(s)
I, _______________________________________, have received/inspected the above mentioned documents.
Print Name
Signature: _____________________________________________________ Date: _______________________
NOTE: This FOIA records request form is subject to the provisions of the Illinois Freedom of Information Act upon being filed with the Village of Algonquin.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business