Emergency Services FOIL Request

Records Requested From *

First Name *

Last Name *

Address *

Address

City

State

Zip

Email *

Contact Phone *

Fax Number

Short Title of Requested Records *

Information provided here helps the agency easily identify and categorize your request.

FOIL Request / Description of records sought: *

Please provide a clear description of the record(s) sought. Personal, private, sensitive, financial, medical, or health-related information should not be put into the “Description” field, and should instead be uploaded in a separate document.

Upload Document(s) in support of your FOIL request:

Drop your file here or click here to upload You can upload up to 4 files.

File types allowed: pdf, xlsx, xls, doc, docx, jpg, zip

Requested Response Format: *

If fees apply, please contact me if costs will be greater than:

I understand that I will be notified if the fees exceed this amount prior to my request being filled.

I am requesting this information for the following reason (may select more than one):

I am an individual seeking information for personal use.
I am affiliated with an educational or non-commercial scientific institution, and this request is made for a scholarly or scientific purpose.
I am a representative of, or affiliated with, the news media and this request is made as part of a news gathering effort.
I am affiliated with a private corporation and am seeking information for use in the company’s business for commercial purpose.
I am affiliated with a private corporation and am seeking information for use in the company’s business for non-commercial purpose.

The foregoing information will be used for statistical purposes.

Name