FREEDOM OF INFORMATION ACT (FOIA) REQUEST FORM 

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TO:            Northeastern Illinois Planning Commission

FROM:     

RE:             REQUEST FOR NOTIFICATION AND ACCESS
 

1. This is a request under the Freedom of Information Act, 5 USC 552.
    

2. I understand the penalties provided in 5 USC 552a(i)(3) for requesting, or obtaining access to records, or information, under false pretenses.
    

3. If some of this request is exempt from release, please send me those portions reasonably separable and provide me with an itemization and justification, in writing, explaining the reasons for the exemptions and material, information, documents, and/or records that is not being released.
    

4. This is my firm promise to pay fees and costs for reviewing and duplication the records and documents requested.
    

5. This requester is requesting notification and access for copies of the following records:
    

6. Please state the reason you are requesting these records:

 

 

I swear and affirm, under the penalties of perjury, that these representations are true, that I have personal knowledge of the facts stated herein, that I am competent to testify to the facts stated herein, and that this document is admissible in court as evidence.

 

DATED: _____________________                      SIGNED: ____________________________________

NAME: ______________________                      ADDRESS: __________________________________