EmailMe Form - Centralia Township FOIA Request via E-Mail

Date of Request

MM / DD / YYYY HH : MM AM/PM

Name of Requestor

First Last

Method of Return

Email

Fax

### - ### - ####

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Records Requested:
Provide as much specific detail as possible so the public body can identify the information that you are seeking.

Is this request for a Commercial Purpose?
(It is a violation of the Freedom of Information Act for a person to knowingly obtain a public record for a commercial purpose without disclosing that it is for a commercial purpose, if requested to do so by the public body. 5 ILCS 140.3.1(c)).

Yes

No

Are you requesting a fee waiver?
(If you are requesting that the public body waive any fees for copying the documents, you must attach a statement of the purpose of the request, and whether the principal purpose of the request is to access or disseminate information regarding the health, safety and welfare or legal rights of the general public. 5 ILCS 140/6(c)).

Yes

No