Public Records (FOIA) Request Form - (Not Police)

2. Name of Requestor*

4. Company (if applicable)

6. Street Address*

8. City*

9. State

10. Zip

12. Daytime Phone Number*

14. Email*

15. Fax

17. Request is for:*

    1. Copies of Records

    1. Inspection of Records

19. Are the public records requested for a commercial purpose?*

    1. No

    1. Yes

20. A request is considered to be for a commercial purpose when the requester seeks to use part or all of the public records for sale, resale, or solicitation or advertisement for sales or services. Requests by the news media, not-for-profit organizations, scientific or academic institutions are not considered commercial purpose requests.

    A request is considered to be for a commercial purpose when the requester seeks to use part or all of the public records for sale, resale, or solicitation or advertisement for sales or services. Requests by the news media, not-for-profit organizations, scientific or academic institutions are not considered commercial purpose requests.

22. Is this a Land Use, Property and/or Building Permit Record Request?*

    1. Yes

    1. No

    If yes, please complete Property Location and Property Ownership questions below.

24. Property Location (address, PIN number if available)

26. Are you the owner of the subject property in question?*

    1. No
    2. Yes

    1. Not Applicable

28. Please describe below the public records you are requesting. Please be as specific as possible, omissions could result in processing delays.

30. Name of Employee Receiving Request

32. Assigned Department / Division

    1. Admin
    2. Finance
    3. Human Resources
    4. IS

    1. Planning
    2. Police
    3. Village Services

34. If Village Services, what division?

36. Due Date

37. FOI Log Number

Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field