Your name or your company's name
Your address or your company's address
Your phone number (optional)
Date
For Secret Servicepolicy and procedure agency records send request to:
Dear Disclosure Manager:
This is a request under the Freedom of Information Act/Privacy Act.
I request that a copy of the following documents (identify the documents or information as specifically as possible) be provided to me. I do not wish to inspect the documents first. In order to determine my status for the applicability of fees, you should know that I am (insert a suitable description of the requester and the purpose of the request).
[Sample requester descriptions (please choose only one if applicable):
A Media Requester: a representative of the news media affiliated with the XXXX newspaper (magazine, television station, etc.), and this request is made as part of newsgathering and not for a commercial use.
An Educational Institution Requester or a Non-Commercial Scientific Institution Requester affiliated with an educational or noncommercial scientific institution, and this request is made for a scholarly or scientific purpose and not for a commercial use.
A Commercial-Use Requester affiliated with a private corporation, seeking information for use in the company's business.
An “Other” Requester seeking information for personal or non-commercial use.]
As proof of identity I am including a photocopy of my driver’s license, notarized declaration, sworn statement, etc. (See “Establishing Proof of Identity and Right to Access”)
I am willing to pay fees for this request up to a maximum of $XX. If you estimate that the fees will exceed this limit, please inform me first.
Thank you for your consideration of this request.
Sincerely,
[your signature]
