Washington Office FOIA Coordinator
WO-560 750 LS
Bureau of Land Management
1849 C Street, NW
Washington, DC 20240
Re: Freedom of Information Act Request
This is a request under the Freedom of Information Act. I request that a copy of the following documents, or documents containing the following information, be provided to me: (If known, you should include any file designations or descriptions of the records you want. You do not have to give a requested record's name or title, but the more specific you are the more likely it will be that the record you seek can be located quickly. You should also include a time-frame for the records you are requesting not the words “all records” for a particular subject, if possible.).
In order to help to determine my status to assess fees, you should know that I am... (sample descriptions listed below, if these options are not applicable, explain your circumstances).
- A representative of the news media affiliated with the _____ newspaper (magazine, television station, etc.). This request is made as part of news gathering and not for commercial use.
- Affiliated with an educational or noncommercial scientific institution. This request is made for a scholarly or scientific purpose and not for commercial use.
- An individual seeking information for personal, not commercial use.
- Affiliated with a private corporation seeking information for company business use.
Choose one of the following fee options:
- I am willing to pay fees for this request up to a maximum of $_____. If you estimate that the fees will exceed this limit, please inform me prior to processing request.
- I request a waiver of all fees for this request. Disclosure of the requested information to me is in the public interest because it is likely to contribute significantly to public understanding of the operations or activities of the government and is not primarily in my commercial interest. (Include specific details, including how the requested information will be disseminated by the requester for public benefit.)
[Electronic format option] I request that the information I seek be provided in electronic format, and I would like to receive it on a personal computer disk (or a CD-ROM).
[Telephone number option] I may be called at the telephone number listed below during the hours of ______ to discuss my request, if necessary.
City, State, Zip Code