Freedom of Information Act Request Form
Privacy Act Statement
Authority: 5 USC 301: 5 USC 562
Principal Purpose: To obtain necessary information so that a response
can be provided to your FOIA request.
Routine Use: Your request may be referred to another Federal agency.
If the record(s) you seek originated with that agency.
Disclosure: Voluntary: However, no reply can be given if the requested
information is not furnished.
(Fields with an asterisk(*) in them are necessary in order to respond to your request)
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