Freedom Of Information Act Request Form
Download a blank fillable Freedom Of Information Act Request Form 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 Act Request Form 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
1Freedom of Information Act Request Form
Hodgkins Police Department
6015 Lenzi Avenue
Hodgkins, Il 60525
(708) 352-4623 Fax: (708) 579-6712
Requestor's Name:
Telephone:
Address:
City:
State:
Zip:
RECORDS SOUGHT: Mark records requested below. Please be specific. ( Report number, dates, names of parties involved)
Printed Records: ________________________________________________________________
Requestor’s Signature ______________________________________________________________
Return completed FOIA form to the FOIA Officer at, Hodgkins Police Department 6015 Lenzi Avenue Hodgkins, IL 60525.
Attn: FOIA or fax your request to (708) 579-6712. The FOIA Officer will respond to a request for public records within 5 working
days after receipt. (Once a denial of request is enacted a 21 day extension begins)
___________________________________________________________________________
(FOR DEPARTMENT USE ONLY)
Those parts of your request which have been approved:
Are Enclosed
Will be made available upon payment of copying costs in the amount of $___________
May be inspected at:
Date:
The following portions of your request have been denied for the reasons cited:
FOI Exemption 140/7(1)(a) in that the information is specifically prohibited from disclosure by federal or state law.
Specifically the Juvenile Court Act
FOI Exemption 140/7(1)(b) in that the information is private information that is unique to that individual and therefore may
not be released in order to prohibit any concern of identity theft
FOI Exemption 140/7(1)(c) in that the information contains personal information whereas the disclosure could
constitute an unwarranted invasion of personal privacy.
FOI Exemption 140/7(1)(d)(i) in that the information would interfere with pending law enforcement proceedings
FOI Exemption 140/7(d)(iii) in that the case is still pending in court and could create the substantial likelihood that a person
would be deprived a fair trial.
FOI Exemption 140/7(d)(iv) in that the information would unavoidably disclose the identity of a person who filed a
complaint with or provided information to an investigative or law enforcement agency.
FOI Exemption 140/7(1)(d)(v) in that the information would disclose unique or specialized investigative techniques.
The individuals who have reached the determination that the record (s) you have requested are to be denied are:
NAME: _________________________________________ Title: Administrative Assistant/Deputy FOIA Officer
Request for Review:
Public Access Bureau
500 S. 2nd Street
Springfield, IL 62706
1-877-299-3642
publicaccess@atg.state,il.us
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business