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2. 
4. FREEDOM OF INFORMATION LAW (FOIL) REQUEST FORM
6. Date*
8. This request pertains to records maintained by the (list city department or board):*
10. Records Access Officer for above-named city department or board:*
    A link to the list of Records Access Officers may be found on the FOIL page of the city website.
12. Pursuant to New York Freedom of Information Law, I am requesting an opportunity to:*

    1. Inspect copies of the following public records
    2. Obtain copies of the following public records
14. Documents requested:*
    Be specific. Describe the record with sufficient detail for the public agency to respond.
16. Requestor's Name*
18. Representing
20. Street Address:*
22. City, State & Zip Code*
24. Phone Number*
25. Email*
27. Requestor's Signature:*
31. AGENCY USE ONLY - Fees (if applicable):
    Please note: There is a photocopying fee of .25 per standard size page, and a $5.00 per page fee for large format plans or maps. Postage fees in the exact amount as levied by the United States Post Office, if mailed.
33. AGENCY USE ONLY - Date Received:
35. AGENCY USE ONLY:

    1. Request Approved
    2. Request Denied
Leave This Blank:


36. Print Only

* indicates a required field