FOIA REQUEST FORM

Village of Crete

FOIA Request Form

Please Print Clearly

Date*

Date

Name*

First NameLast Name

Organization*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Email*

example@example.com

Pursuant to the Freedom of Information Act, Chapter 5 ILCS 140, I request:*

CopyInspectionCertification

Describe as accurately and specifically as possible the public records you are requesting To expedite the search be as specific as possible If known include dates of requested Records*

Note: "Commercial purpose" means the use of any part of a public record or any information derived from a public record for sale, resale, or solicitation or advertisement for sales or services. It is a violation of the Freedom of Information Act to knowingly obtain information for a commercial purpose without disclosing that intent to the Village of Crete. Each request for a public record or category of public records made in violation of this requirement (whether made as part of a single or multiple written requests) shall be subject to a fine of $750 and such other penalties allowed by law.

Is this request being made for commercial purposes?*

YesNo

Signature of person making the request:*

Date

Send requests to:

Village of Crete, FOIA Officer

P.O. Box 337

Crete, IL 60417

Facsimile: 708-672-3920, Email: msmith@villageofcrete.org