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

Foia Request For Records Form - City Of Lake Forest Page 4

Request Form

mailing before the records will be mailed. It would be unduly burdensome for me

to pick up the requested records at the City Hall because:

__________________________________________________________________

___

I do not request mail delivery of any of the requested public records.

Requestor

Name of Requestor: ________________________________________________

Name of person for whom records are being requested (if not Requestor):

__________________________________________________________________

Address for Responses, Decisions, and Communications:

__________________________________________________________________

Telephone Numbers of Requestor:

Day:

____________________________________________________________

Evening: _________________________________________________________

E-mail: ___________________________________________________________

Signature of Requestor

By signing this Request, I acknowledge and represent that I have reviewed, and that I

understand, The City of Lake Forest Rules and Regulations for Implementation of the

Illinois Freedom of Information Act and that all of the information provided in support of

this request is true and accurate.

________________________________________________

Signature of Requestor

________________________________________________

Date

Foia Request For Records Form - City Of Lake Forest Page 4