Pontiac
Fee Appeal Form
City:
47450 Woodward Ave
Pontiac
48342
758-3200
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FOIA Appeal Form—To Appeal an Excess Fee
Michigan Freedom of Information Act, Public Act 442 of 1976, MCL 15.231, et seq.
Request No.:
(Please Print or Type)
Request for:
Delivery Method:
Record(s) You Requested: (Listed here or see attached copy of original request) ____________________________________________________
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Reason(s) for Appeal:
by state law or under the City's FOIA Procedures and
Guidelines
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Requestor’s Signature:
Date:
City Response:
The City must provide a response within 10 business days after receiving this appeal, which will include a determination or a notice extending the period
during which the City will respond to the this appeal by not more than 10 business days.
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City Extension:
month, day, year
The reason(s) for this extension are as follows: __________________________________________________________________________________
please
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Fee Reduced to $_______________.
City Determination:
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Notice of Requestor’s Right to Seek Judicial Review
by state law or under
FOIA
Mayor
Oakland
County
Mayor
circuit
See the back of this form for additional information on your rights
Signature of Mayor:
Date: