SARATOGA COUNTY
APPLICATION FOR ACCESS TO RECORDS
I HEREBY REQUEST_(Please include as much detail as possible)_________________________________
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SIGNED___________________________________________________Date___________________________
Print Name________________________________________________________________________________
Mailing Address___________________________________________________________________________
Phone__________________________________Email_____________________________________________
NOTE: Please return completed form to: Therese Connolly, Deputy Clerk of the Board, Saratoga
County, 40 McMaster Street, Ballston Spa, New York 12020, Fax 518-884-4771 or email
foil@saratogacountyny.gov
By submitting online, the typing of your name shall constitute a valid and legal signature for submission
of your request. Saratoga County has the right to rely upon the information submitted and shall assume
no obligations to verify the “signature” provided. Any submission not utilizing the proper and legal
name of the individual requesting the information is subject to denial and/or prosecution.
( ) Approved_____ Pages of records are available for review or copying at 25 cents
per page.
( ) Denied for reason(s) checked
( ) Confidential Disclosure
( ) Part of Investigatory Files
( ) Unwarranted Invasion of Personal Privacy
( ) Record not maintained by this Agency
( ) No records responsive to request found.
( ) Exempted from the Freedom of Information Law by state or federal law
( ) Other (Specify)_________________________________________________
Signed____________________________Title____________________________Date________________
NOTICE: You have the right to appeal a denial of this application within 30 days of the date of the
mailing or emailing of the denial to you. Your appeal must be in writing and filed with the Appeals
Officer, County Attorney Stephen Dorsey, 40 McMaster Street, Ballston Spa, New York 12020 who must
either overrule or sustain such denial in writing within 10 business days of the receipt of such appeal.
I HEREBY APPEAL___________________________________________DATE_______________
