Application for Access to Records
Freedom of Information Law (FOIL)
M O N R O E C O U N T Y , N Y
I hereby apply to inspect or obtain a copy of the following record(s).*
(Please be specic with your request.)
Name Representing (if applicable)
Mailing Address
Telephone (include area code)
City State Zip Code
Signature
Please print, sign and date this form before submitting.
Date
*There is no charge for the inspection of documents; however, if duplication is requested by you, a charge of 25¢ per page is payable to Monroe County.
Notice: You have a right to appeal denial of this application.
Send Request to:
Monroe County Access Ocer
204 County Oce Building • 39 West Main Street • Rochester, NY 14614
585 753-1080 • fax: 585 753-1068 •MonroeCounty.gov