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 specic 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 Ocer
204 County Oce Building • 39 West Main Street • Rochester, NY 14614
585 753-1080 • fax: 585 753-1068 •MonroeCounty.gov
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