Freedom of Information Act Request - City of Champaign Township

Date:*

Name:*

First Last

Postal Address:*

Street Address Address Line 2 City State ZIP Code

Email Address:*

Daytime Phone Number:*

Information Requested:*

Please describe the information/records you are requesting in as much detail as possible. This will enable us to find the records more quickly for you.

I wish to:*

Inspect Only
Inspect and Receive Copies
Receive Copies Only
Receive Certified Copies

Certification of Commercial / Non-Commercial Request

Purpose of Request:*

Request is for a commercial purpose
Request is NOT for a commercial pupose

"Commercial purpose" means the use of any part of a public record or records, or information derived from public records, in any form for sale, resale, or solicitation or advertisement for sales or services. 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.

Signature of Requestor:*

By typing your full name in the box you are certifying that your request is for the purpose selected above.

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