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Denial Appeal Form

Grand Traverse Rural

Office: Keep original and

provide copy of both

Fire Department

sides, along with Public

2266 E. M-113, Suite B

Summary, to requestor at

no charge.

Kingsley, MI 49649

(231) 263-RURL ( 7875)

FOIA Appeal Form—To Appeal a Denial of Records

Michigan Freedom of Information Act, Public Act 442 of 1976, MCL 15.231, et seq.

□ Email

□ Fax

□ Other Electronic Method

Request No.:

Date Received:

Check if received via:

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

City

State

Zip

□ Copy

□ Certified copy

□ Record inspection

□ Subscription to record issued on regular basis

Request for:

□ Will pick up

□ Will make own copies onsite

□ Mail to address above □ Email to address above

Delivery Method:

□Deliver on digital media provided by the GTRFD:

Record(s) You Requested: (Listed here or see attached copy of original request)

Reason(s) for Appeal:

The appeal must identify the reason(s) for the denial. You may use this form or attach additional sheets:

Requestor’s Signature:

Date:

Grand Traverse Rural Fire Department 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 fee 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:

Grand Traverse Rural Fire Department Determination:

□ Denial Reversed

□ Denial Upheld

□ Denial Reversed in Part and Upheld in Part

The following previously denied records will be released:

Notice of Requestor’s Right to Seek Judicial Review

You are entitled under Section 10 of the Michigan Freedom of Information Act, MCL 15.240, to appeal this denial to the county board of

commissioners or to commence an action in the Circuit Court to compel disclosure of the requested records if you believe they were wrongfully

withheld from disclosure. If, after judicial review, the court determines that the county has not complied with MCL 15.235 in making this denial and

orders disclosure of all or a portion of a public record, you have the right to receive attorneys’ fees and damages as provided in MCL 15.240. (See

back of this form for additional information on your rights.)

Signature of FOIA Coordinator:

Date:

(Created by Michigan Townships Association, April 2015)

Foia Appeal Form To Appeal A Denial Of Records - Grand Traverse Rural Fire Department

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