Usps Freedom Of Information Act And Privacy Act Request Report Page 3
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4Freedom of Information Act and Privacy Act Request Report
Must be completed if request cites "Freedom of Information Act," "FOIA," "5 U.S.C. 552," "Privacy Act" or "5 U.S.C. 552a".
(See exceptions in Instructions on reverse.)
1. Date Received (MM/DD/YYYY) 2. Act(s) Cited (Check one)
3. Date Due (MM/DD/YYYY)
FOIA (or Freedom of Information
Privacy Act (or 5 U.S.C. 552a)
Act or 5 U.S.C. 552)
FOIA/PA (both of the Acts)
4. Date(s) Responded
5. Expedited Processing (See instructions)
Month
Day
Year
/
/
Completed Response
Was "expedited processing" requested?
Yes
No
/
/
Partial Response
/
/
Partial Response
Was "expedited processing" granted?
Yes
No
/
/
Partial Response
6. First Party Requests
a. Is the request for COPIES OF/ACCESS TO records about the requester?
Yes
No
b. Is the request for AMENDMENT of records about the requester?
Yes
No
7a. Requester's Name (Last, First, MI)
7b. Requester's Organization (If applicable)
7c. Name of Person on Whose Behalf Request Is Made (Last, First)
8. Description of Records Requested (If multiple types requested, describe up to three):
a.
b.
c.
If same records were previously requested by any other requester, enter a, b, c, as applicable:
9. Records Search (Indicate which apply to each record type (a), (b), and (c) above:
(a) (b) (c)
(a) (b) (c)
(a) (b) (c)
No records exist
Not an agency record
Duplicate request
Records were released in full
Insufficient description
Other (Specify):
Records were denied in part
Fee-related reason
Records were denied in full
Request withdrawn
10. Denial Information (Complete if records are denied in full or in part) (See Instructions)
a. Authority Cited (Check one or more):
Section(s) Cited by Record Type in Item 8: (a)
ASM
CFR
FOIA
Privacy Act
(b)
(c)
b. Name of Person Responsible for the Denial (Last, First)
Title
City
State
ZIP + 4
11. Resources Used (Beside each process, indicate time spent (in hours and/or quarter hours) by professional and/or clerical staff)
Professional Time
Clerical Time
Example:
If searching took 4 1/2 hours, enter 4 under
Total Hours and check 30 minutes.
Total Hours
15 Min.
30 Min.
45 Min.
Total Hours
15 Min.
30 Min.
45 Min.
Reading/Interpreting Request
Searching for Responsive Records
Reviewing Records for Release
Writing Response Letter
Reproducing or Printing Out Records
Other (Specify)
12. Accountability
a. Prepared By Name (Print) (Last, First)
b. Signature
c. Date
d. Office/Facility Name:
e. District and Area or HQ Organization
f. Telephone No. (w/ Area Code)
8170
(FORM RESTRICTED UPON COMPLETION)
PS Form
, October 1998 (Part 2 of 2)
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