SAMPLE FOIA REQUEST LETTER
A sample FOIA request letter is shown below. Keep a copy of your request. You may need to
refer to it in further correspondence with the agency.
CMS FOIA Officer
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244
Under the Freedom of Information Act, 5 U.S.C. subsection 552, I am requesting access to
[identify the records as clearly and specifically as possible].
In order to help you determine my status for the purpose of assessing fees, you should know that
I am [insert one of the descriptions below]
a representative of the news media affiliated with the ______________ news
organization and this request is made as part of news gathering and not for commercial
affiliated with an educational or noncommercial scientific institution, and this request is
made for a scholarly or scientific purpose and not for a commercial use.
affiliated with a private business and am seeking information for use in the company’s
an individual seeking information for personal use and not for a commercial use.
[Optional] I am willing to pay fees for this request up to a maximum of $__. If you estimate that
the fees will exceed this limit, please inform me first.
[Optional] I request a waiver of all fees for this request. Disclosure of the requested information
to me is in the public interest because it is likely to contribute significantly to public
understanding of the operations or activities of the government and is not primarily in my
commercial interest. [Include specific details, including how the requested information will be
disseminated by the requester for public benefit.]
[Optional] I request that the information I seek be provided in electronic format, and I would like
to receive it on a personal computer disk [or a CD-ROM].
[Optional] I ask that my request receive expedited processing because ____. [Include specific
details concerning your “compelling need,” such as being someone “primarily engaged in