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Request for Records - General (FOIA)

2. 

4. Request for Records - General (FOIA)

6. Date of Request*
   Date of Request

8. Name of Person Making Request*

10. Address*

12. City*

13. State*

14. Zip Code*

16. Phone Number*

17. Fax Number

18. Email Address*

20. Address of Property for information you seek*

    If no address, please mark N/A.

22. Describe below the public records you are requesting and state whether you wish to inspect and/or be provided with a copy of such records.*

24. Is this request for commercial purposes*

    1. Yes

    1. No

26. The Village of Channahon will respond to the above request within five (5) working days from the above date unless one or more of the seven (7) reasons for an extension of time provided for in Section 3 (d) of the Freedom of Information Act are invoked by the Village. Any commercial purpose requests have up to twenty-one (21) working days.

28. Signature of Person Making Request*

    Please type full name, or print and sign.

29. Copying Fees are fifteen cents ($0.15) per page AFTER the first 50 pages of black and white for each request. Other fees may apply depending on the request.

33. FOR OFFICE USE ONLY - ROUTING OF REQUEST TO THE FOLLOWING DEPARTMENT:

    1. Administrative
    2. Development

    1. Finance
    2. Police

    1. Public Works

35. Action Taken:

37. Administrator's Signature

38. Processed By:

39. Fee:

41. Date*
    Date

Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit Submit and Print

* indicates a required field