FREEDOM OF INFORMATION REQUEST FORM
THE VILLAGE OF NORWOOD
Name of Requestor: ___________________________________________________________
Printed Name
Address: ___________________________________________________________________
City/State/County & Zip:
________________________________________________________________
Request Submitted By: ____E-mail ____U.S. Mail ____Fax ____In Person
Phone (optional): ____________ E-Mail (optional) _____________ Fax (optional) _________
RECORDS SOUGHT: Mark records requested below. Please be specific.
Printed Records: ________________________________________________
________________________________________________
________________________________________________
Other:
________________________________________________
Do you want copies of the documents? YES NO (Note: Fee for each copied page is 25¢/ page
or $2.00/CD)
Requestor's Signature ___________________________
Return completed FOIA Request Form to: Village of Norwood, 1515 N. Norwood
Blvd., Peoria, Illinois 61604; or e-mail to: 1norwood@comcast.net
If your request is denied, you may file an appeal to: Sara Pratt, Public Assess Counselor,
Office of the Attorney General, 500 S. 2nd Street, Springfield, Il. 62706 or e-mail:
publicaccess@atg.state.il.us or call 1-877-299-3642
_______________________________________________________________________
(FOR DEPARTMENT USE ONLY)
RESPONSE:
Records made available:
Date _______________________________________
Request denied, and reason:
___________________________________________
___________________________________________
Copies made:
Yes
No
Number _______
Fee Paid $______
Date Stamp Receipt
Other (attach correspondence):
___________________________________________________
___________________________________________________