Marty P. Leffler
Freedom of Information
Request for Examination or Copy of Records
Requester’s Information: Date of Request: _______________________
Name: _____________________________________ Phone: ______________________________
Address: ___________________________________ City/State: ____________________________
Relationship to Decedent: ___________________________________________________________
Name of Decedent: ______________________________ Date of Death: _____________________
Records Requested & Fee Scale:
Autopsy Report ($50.00) Autopsy Photos ($3.00 per Photo)
Coroner’s Report ($25.00) Scene Photos ($3.00 per Photo)
Toxicology Report ($25.00) Inquest Verdict ($5.00)
Inquest Transcript ($5.00 per page)
Other (Please specify request): __________________________________________________
NOTICE: Should your request be denied in full or part, you will be notified by separate letter. If so,
the below information will be applicable.
Request for Review: If your request for records has been denied, in whole or in part, you have the
right to appeal this decision by contacting:
Illinois Attorney General’s Office
Public Access Review
500 S. 2
Springfield, Illinois 62706
1 (217)558-0486
You may also appeal your denial to the Franklin County Circuit Court.
Franklin County Coroner
County of Franklin, Illinois
411 East Main Street
Benton, Illinois 62812
618-439-6850 Ext. 2501