Foia Request Form printable pdf download

West 40 ISC #2

FOIA Request Form

4413 Roosevelt Road

Hillside, IL 60162

Phone: 708-449-4284

Requestor’s Name:_____________________________________________________

Address:___________________________________________________________________________________________________

Telephone Number:________________________________________

E-mail:___________________________________________________

Organization:_____________________________________________

I would like to receive the response via (Please check): E-mail:_____

Hardcopy:_____

Date Received (Office Use Only):_____________________________

Record’s Requested (Please be specific):

______________________________________________________________________________________________________

This request is being made for a commercial purpose. Section 2(c-10) of FOIA defines

“commercial purpose"

as the use of any part of a public record or records, or information derived from public records, in any form for sale,

resale, or solicitation or advertisement for sales or services. For purposes of this definition, requests made by news

media and non- profit, scientific, or academic organizations shall not be considered to be made for a "commercial

purpose" when the principal purpose of the request is (i) to access and disseminate information concerning news and

current or passing events, (ii) for articles of opinion or features of interest to the public, or (iii) for the purpose of

academic, scientific, or public research or education.

I will allow an extra 5 days (10 total) for West 40 to prepare the information I have requested.

Signature:_________________________________________

Foia Request Form