Police Request for Public Records – City of Breese, Illinois

The Freedom of Information Act, 5 ILCS 140 et seq., is the principal Illinois statute governing the inspection of public records. The Act requires that public bodies make available for inspection or copying all public records to any person. Exceptions are provided to insure the confidentiality of certain types of sensitive public records.

Requestor Information

Name:

First Name

Last Name

Business Name:

Address:

City

State/Province

Zip/Postal

Primary Phone Number:

Secondary Phone Number:

Email:

Document Information

Is this request being used for a commercial purpose?

Yes

No

It is a violation of the Freedom of Information Act for a person to knowingly obtain a public record for commercial purpose without disclosing that it is for a commercial purpose, if requested to do so by the public body. (5ILCS 140.31(c)). Each request for public record or category of public records made in violation of this requirement (whether made as part of a single or multiple written request) shall be subject to penalties allowed by law.

Do you wish to (check one):

Schedule a review of the document(s)

Pick up a hard copy of the document(s) at City Hall

Receive the document(s) via email

Please be aware that, due to file size, not all documents will be eligible for email delivery. If the Police Department is unable to provide documents electronically, the requestor will be contacted to discuss alternate arrangements.

Describe as specifically as possible the record(s) or document(s) sought:

Date(s) of record(s) or document(s):

Agreement to Pay Fees:

I will pay the following fees for public records copied at my request. Payment may be required prior to processing the request. Charges for black and white and color copies, letter or legal size are free for the first 50 pages, and $0.15/page thereafter. For abnormal size copies, the charge is the actual cost of reproducing the copy. If electronic records are provided on a physical medium (such as a flash drive, CD or DVD), the fee will reflect the actual cost of that medium. If the request serves a public interest rather than a personal one, and the requester explains the specific purpose, fees may be reduced or waived. For commercial purposes and voluminous requests, charges will be assessed in accordance with applicable law.

Acknowledgement

I hereby certify and affirm that the above information is true and correct and that by checking this box constitutes a legal signature confirming my request for public records.

Electronic Signature:

First Name

Last Name

Date

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