Foia Request Form - Village Of Shorewood printable pdf download

FOIA Request Form

Village of Shorewood

One Towne Center Blvd.

Shorewood, IL 60404



Phone (815)725-2150

Fax (815)741-7709

To:

VILLAGE CLERK

VILLAGE OF SHOREWOOD

1.) Under the Freedom of Information Act of the State of Illinois, I hereby request access to a copy of the

following record(s):

__________________________________________________________________________________

(Describe as accurately and specifically as possible the record(s) you are requesting and provide all of

the relevant information you have concerning them. Enclose a copy of any document similar to that

requested, if you have such a document in your possession.)

2.) The record(s) I am requesting is/are maintained by the following department, board, or agency of the

Village of Shorewood (if known):

___________________________________________________________________________________

3.) I hereby agree to pay the fee imposed for copies of the requested records in accordance with the schedule

of fees published by the Village of Shorewood. However, if the fees exceed $________, please inform

me prior to copying and supplying the records.

NAME OF PERSON/ORGANIZATION: ___________________________________________________________

_____________________________________________________________________________________________

ADDRESS: __________________________________________________________________________________

TELEPHONE: ________________________________________________________________________________

DATE OF REQUEST: __________________________________________________________________________

--------------------------------------------------------------------------------------------------------------------------------------------

FOR OFFICE USE ONLY:

Received by: __________________________________________________________________________________

Date Request Received: __________________________________________________________________________

Foia Request Form - Village Of Shorewood