Foia Request For Records Form - City Of Lake Forest (Page 3 of 4) in pdf

Foia Request For Records Form - City Of Lake Forest Page 3

Request Form

I request a waiver of the fees set forth in Subsection A above, and in support of my

request I hereby certify that I will gain no significant personal or commercial

benefit from the public records herein requested and that my principal purpose in

making this request is to benefit the general public by disseminating information

concerning the health, safety, welfare, or legal rights of the general public in the

following specific manner:

_______________________________________________________________

Purpose of Request

Please check Yes or No for each of the following questions:

Yes

A. I am requesting the public records identified in Section 1 above

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to use the records, or the information derived therein, for sale,

resale, solicitation, or advertisement for sales or services.

B. I am, or represent, news media or a non-profit, scientific

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or academic organization.

C. The principal purpose of this Request for Public Records is to

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access and disseminate information concerning news and current

or passing events.

D. The principal purpose of this Request for Public Records is for

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articles of opinion or features of interest to the public.

E. The principal purpose of this Request for Public Records

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is academic, scientific, or public research or education.

Pursuant to Section 3.1(c) of the Freedom of Information Act, it is a violation of

the Act for a person to knowingly obtain a public record for a commercial purpose

without disclosing that it is for a commercial purpose. Each request for a public

record or category of public records made in violation of this requirement (whether

made as part of a single or multiple written requests) shall be subject to a fine of

$750 and such other penalties allowed by law.

Request for Mail Delivery

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I request that the City mail copies of the requested public records to me at the

address set forth in Section 5 below. I hereby agree to pay the actual postage for

Foia Request For Records Form - City Of Lake Forest Page 3