Foia Appeal Form
ADVERTISEMENT
1
2St. Clair County Administration/Controller’s Office
County: Keep original and
200 Grand River Ave. Suite 203
provide copy of both sides,
Port Huron, MI 48060
along with Public Summary,
Tel: (810) 989-6900
to requestor at no charge.
Fax: (810) 985-3463
FOIA Appeal Form
Michigan Freedom of Information Act, Public Act 442 of 1976, MCL 15.231, et seq.
Denial of Records
Excess Fee
Request No.: __________
Date Received: ___________
Check if received via:
Email
Fax
Other Electronic Method
Date of This Notice: _________________
Date delivered to junk/spam folder: _______________
Date discovered in junk/spam folder: _______________
(Please Print or Type)
Name
Phone
Firm/Organization
Fax
Street
Email
City
State
Zip
Request for:
Copy
Certified copy
Record inspection
Subscription to record issued on regular basis
Delivery Method:
Will pick up
Will make own copies onsite
Mail to address above
Email to address above
Deliver on digital media provided by the county: ________________________________________________________________
Record(s) You Requested: (Listed here or see attached copy of original request) ____________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
Reason(s) for Appeal:
The Denial of Records appeal must identify the reason(s) for the denial. The Excess Fee appeal must specifically identify how the required fee(s)
exceed the amount permitted. You may use this form or attach additional sheets:
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
Requestor’s Signature: ______________________________________________________________________________Date: ______________
County Response:
The county must provide a response within 10 business days after receiving this appeal, including a determination or taking one 10-day extension.
County Extension: We are extending the date to respond to your FOIA appeal for no more than 10 business days, until ________________
(month, day, year). Only one extension may be taken per FOIA appeal.
Unusual circumstances warranting extension: _________________________________________________________________________________
______________________________________________________________________________________________________________________
If you have any questions regarding this extension, contact: ______________________________________________________________________
County Determination:
Denial Reversed
Denial Upheld
Denial Reversed in Part and Upheld in Part
Fee Waived
Fee Reduced
Fee Upheld
The following previously denied records will be released:
Written basis for county determination
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
(See back of this form for additional information on your rights.)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business