APPENDIX A: FORMS
FREEDOM OF INFORMATION ACT REQUEST
TO BE FILLED IN BY REQUESTOR:
DATE: __________________   NAME: _____________________________________________
ADDRESS: _____________________________________________________________________
TELEPHONE NUMBER (BETWEEN 8:00 A.M. AND 5:00 P.M.): ______________________
________________________________________________________________________________
Approximate date of Document: _____________________________________________________
Department: _____________________________________________________________________
Category: _______________________________________________________________________
Other Information/Remarks: ________________________________________________________
Request to (Check One):
A.   Inspect Only                  [   ]
B.   Inspect and Receive Copies         [   ]
C.   Receive Copies Only            [   ]
D.   Inspect and Receive Certified Copies      [   ]
E.   Receive Certified Copies Only         [   ]
Signature: _______________________________________
   RESPONSE TO FREEDOM OF INFORMATION ACT REQUEST
TO: ____________________________________      DATE: ____________________________
   (Requestor’s Name)
   ____________________________________
   (Address)
   ____________________________________
   (City, State, Zip)
   ____________________________________
   (Telephone Number)
FROM: ____________________________________   ___________________________________
      (Name)                           (Job Title)
Concerning your request for information dated ______________________.
______   1.   No such document(s) have been located.
______   2.   An extension of time until ___________________ is needed because:
   _____ a.  the records are stored in another place.
   _____ b.  many records are being requested.
   _____ c.  an extended search is being conducted.
   _____ d.  the records are being examined to determine if any information is exempt.
   _____ e.  we need additional time to respond due to the operating needs of the department.
______   3.   Your request appears to be for so many records that it would be unduly burdensome for us to comply. Please contact us to see if the request can be clarified and be reduced to a manageable level.
______   4.   Your request is being denied because you have previously received this information from us.
You have the right to appeal to the Village Board. Please contact the Clerk for information on how to do so.
VILLAGE OF TOLONO
___________________________________
Village Clerk
   REQUEST FOR WAIVER OF FEE OR REDUCED CHARGE
Pursuant to the state’s Freedom of Information Act, the undersigned hereby certifies:
1.   That the undersigned desires to inspect and copy the following described documents:
2.   That the undersigned seeks to receive these documents without fee or at a reduced charge:
3.   That the purpose for this document request is as follows:
4.   That waiver or reduction of the duplication fee is in the public interest, specifically*:
Date: ____________________      ______________________________________________
                        (Name)
                        ______________________________________________
                        (Address)
                        ______________________________________________
                        (City, State, Zip)
   *NOTE: A fee waiver/reduction will be granted only if it appears that the principle purpose of the request is to access and disseminate information regarding health, safety, and welfare or the legal rights of the general public and is not for the principle purpose of personal or commercial benefit.
FOR OFFICE USE ONLY:
Date: ___________________________
________________________________            ____________________   Approved
Village Clerk
                                    ____________________   Denied
   DENIAL OF FREEDOM OF INFORMATION AT REQUEST (POLICE DEPARTMENT)
TO: _____________________________________________   DATE: _______________________
   (Requestor’s Name)
   _____________________________________________________________________________
   (Address)                     (City, State, Zip)               (Telephone)
FROM: ___________________________________________         ______________________
      (Name)                                    (Job Title)
Your request of _____________________ for ___________________________________________
                                       (describe document)
___________________ is denied in full _____________________; in part ____________________;
   _________ A.   It is information which would constitute a clearly unwarranted invasion of personal privacy and for which no consent in writing by the individual involved has been received.
   _________ B.   It is information revealing the identity of persons who file complaints with or provide information to administrative, investigative, or law enforcement divisions of the village.
   _________ C.   It is a record compiled for administrative enforcement proceedings or for law enforcement purposes or for internal matters of a public body, and disclosure would:
            ___   1)   interfere with pending or actually and reasonably contemplated law enforcement proceedings conducted by any law enforcement or correctional agency;
            ___   2)   interfere with pending administrative enforcement proceedings conducted by any public body;
            ___   3)   unavoidable disclose the identity of a confidential source or confidential information furnished only by the confidential source;
            ___   4)   endanger the life or physical safety of law enforcement personnel or any other person; or
            ___   5)   obstruct an ongoing criminal investigation.
   _________ D.   It is criminal history record information maintained by state or local criminal justice agencies not otherwise publicly available.
   _________ E.   Other.
You have the right to appeal this denial to the Village Board. Please contact the Clerk for information on how to do so.
_______________________________________
(Chief of Police)
   DENIAL OF FREEDOM OF INFORMATION ACT REQUEST (DEPARTMENTS OTHER THAN POLICE)
TO:   _____________________________________
      (Requestor’s Name)
      _____________________________________
      (Address)
      _____________________________________
      (Telephone Number)
FROM:   _____________________________________
      (Names)
      _____________________________________
      (Job Title)
Your request of __________________ for ______________________________________________
________________________________________ is denied _________ in full/________ in part:
(describe document requested)
   ____ A.   It is information revealing the identity of persons who file complaints with or provide information to administrative, investigative, or law enforcement divisions of the village.
   ____ B.   Architects’ plans and engineers’ technical submission for projects not constructed or developed in whole or part with public funds or for projects constructed or developed with public funds, to the extent that disclosure would compromise security.
   ____ C.   Other: _________________________________________________________________
                     (Detail Reason)
         _______________________________________________________________________
You have the right to appeal the denial to the Village Board. Please contact the Clerk for information on how to do so.
_____________________________________
(Village Clerk)
TO:      BOARD OF TRUSTEES
VILLAGE OF TOLONO
P.O. BOX 667
TOLONO, IL 61880
FROM:      ____________________________________________
         (Name)
         ____________________________________________
         (Address)
         ____________________________________________
         (City, State, Zip)
         ____________________________________________
         (Telephone Number)
   NOTICE OF APPEAL TO HEAD OF PUBLIC BODY
   FROM DENIAL OF ACCESS TO PUBLIC RECORDS
   I hereby appeal, pursuant to the provisions of the state’s Freedom of Information Act, to the Board of Trustees from denial to me, in whole or in part, of access to public records.
   I made a  written  request for the following records: (be specific)
   My request was denied _______ in whole, or _______ in part (check one) on ___________,
                                                      (Date)
by ________________________________________, _____________________.
      (Name)                           (Title)
   Copies of my written request and the notice of denial and the reasons therefore are attached.
   My appeal should be granted because: ____________________________________________
________________________________________________________________________________
   _______________________         _______________________________
   (Date)                        (Appellant’s Signature)