General FOIA Request Form
Send to: 601 Avenue A
Springfield, MI 49037
OR
Date Requested:_______________________________________________________________________
Name of Requestor:_____________________________________________________________________
Requestor’s Address:____________________________________________________________________
City/State/ZIP:__________________________________________________________________
Telephone Number:_____________________________ Fax Number:____________________________
E-Mail Address:________________________________________________________________________
Please describe in detail the public records you are requesting
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Signature of Requestor:_____________________________________________
The City of Springfield will respond to this request within five (5) working days from the date the request
was received. The City may notify you that it will take an additional ten (10) days to respond.
_____________________________________________________________________________________
OFFICE USE ONLY
Date request was received:______________________
Request: Denied – Granted – Granted in Part
Date request was responded to:_______________________ Response method: Email – Mail