Freedom Of Information Request Form
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1Quincy Police Department
Freedom of Information Request Form
Quincy Police Dept.
Name:
110 S. 8th Street
Address:
Quincy, IL 62301
City, State, Zip:
Phone: 217-228-4470
Phone:
Fax: 217-228-4513
Email address:
e-mail:foia-qpd@
Person you are representing:
quincyil.gov
Commercial purpose:
Yes _____ No _____
Please complete this section:
Person(s) involved in case:
Date(s) of birth:
Type of offense:
Case file #:
Date and location of offense:
:
This part is optional, but will assist us in providing information
Description and reason for request for records (please be specific):
Please choose one:
Inspect records _____
Copy records _____
Requestor’s Signature: ________________________________________
Date: ________________
For office use only:
Name/Title of person
receiving request:
Date:
Due date:
Request #:
Pending case: Yes ____ No ____
Approved ____ Denied ____
Interfere with prosecution: Yes ____ No ____
Signature of Reviewer:
Date:
Notes/comments:
If an FOI request is denied, the requestor has a right to appeal the denial to the Public Access Counselor (PAC) at the Attorney General’s
Office. Public Access Counselor, Office of the Attorney General, 500 S. 2nd Street, Springfield, Illinois 62706, 877-299-3642,
publicaccess@atg.state.il.us. The requestor also has the right to judicial review.
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