Homewood Public Library District Freedom Of Information Request Template printable pdf download

Homewood Public Library District Freedom Of Information Request Template

HOMEWOOD PUBLIC LIBRARY DISTRICT

FREEDOM OF INFORMATION REQUEST

** Note to Requestor: Retain a copy of this request for your files. If you eventually need to file a Request

for Review with the Public Access Counselor, you will need to submit a copy of your FOIA request. **

Request Submitted By: ______ E-mail

_______ U.S. Mail

_______ FAX

_______ In Person

Requestor's Name (or business if applicable):

Date of Request:

Telephone (Optional):

Street Address:

Certification Requested:

_______ Yes

_______ No

City, State, Zip Code:

FAX (Optional):

E-mail (Optional):

Description of Records Requested:

Do you want copies of the documents? _______ Yes

_______ No

-- Do you want Electronic Copies or Paper copies? _______________________________

-- If you want Electronic Copies, in what format? ________________________________

Is this request for a Commercial Purpose? _______ Yes

_______ No

(It is a violation of the Freedom of Information Act for a person to knowingly obtain a public record for

a commercial purpose without disclosing that it is for a commercial purpose, if requested to do so by

the public body. 5 ILCS 140.3.1(c)).

Are you requesting a fee waiver? _______ Yes

_______ No

(If you are requesting that the public body waive any fees for copying the documents, you must attach

a statement of the purpose of the request, and whether the principal purpose of the request is to

access or disseminate information regarding the health, safety and welfare or legal rights of the

general public. 5 ILCS 140/6 (c)).

Homewood Public Library District Freedom Of Information Request Template