Sample FOIA Request
**Note to Requester: Retain a copy of this request for your files. If you eventually need to file a Request for Review
with the Public Access Counselor, you will need to submit a copy of your FOIA request.**
Name and Address of Public Body Receiving Request:
Illinois Tollway, 2700 Ogden Avenue, Downers Grove, IL 60515
Date Requested: ____________________ Request Submitted By: Email U.S. Mail Fax In Person
Name of Requester: ____________________________________________________________________________
Street Address: ________________________________________________________________________________
City/State/County/ZIP: _________________________________________________________________________
Telephone: _________________________________ Email: ____________________________________________
Fax: _______________________________________
Records Requested: ____________________________________________________________________________
Do you want copies of the documents? Yes No
Paper Copies Electronic Copies If electronic, what format? _________________________________
Is this request for a Commercial Purpose? Yes No
(It is a violation of the Freedom of Information Act for a person to knowingly obtain a public record for a commercial
purpose without disclosing that it is for a commercial purpose, if requested to do so by the public body. 5 ILCS
Are you requesting a Fee Waiver? Yes No
(If you are requesting that the public body waive any fees for copying the documents, you must attach a statement of
the purpose of the request, and whether the principal purpose of the request is to access or disseminate information
regarding the health, safety and welfare of legal rights of the general public. 5 ILCS 140/(6)).