Note: Please keep a copy of your request letter. You may need to refer to it in further correspondence with the agency.

Date

FOIA Officer
Name of Agency
Address of Agency
City, State, Zip Code

Re: Freedom of Information Act Request

Dear [            ]:

This is a request under the Freedom of Information Act (FOIA).

I request that a copy of the following documents be provided to me: [identify the documents or information as specifically as possible].

In order to help you determine my status for the applicability of any fees, I am requesting these documents for a [choose one: commercial, educational, media or other] purpose. [Describe purpose of the request, for example, I am affiliated with an educational institution and the request is made for a scholarly or scientific purpose and not for a commercial use.]

If there are any fees for searching for or copying the documents, please let me know before you process my request. [Or, 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 contact me.]

If you deny all or any part of this request, please cite each specific FOIA exemption that justifies your denial and notify me of appeal procedures available under the law. If you have any questions about processing this request, you may telephone me during business hours at [telephone number].

Sincerely,
[Signature]
Print Name
Address
City, State, Zip Code
Telephone number
[Optional: Fax number]
[Optional: Email address]