Fill and Sign the 11313 Freedom of Information Actinternal Revenue Service Irsgov

- 1 - Instruction: This is a model letter. Adapt to fit your facts and circumstances. Re: FREEDOM OF INFORMATION ACT REQUEST LETTER Dear : This is a request under the Freedom of Information Act. I request a copy of the following document(s) be provided to me: (identify the records and/or information requested to include dates, places, names, and any other specific data) In order to help you determine my status for the purpose of assessing fees, you should know that I am (insert one of the descriptions below) . (1) A representative of the news media affiliated with the newspaper (magazine, television station, etc.) And this request is made as part of newsgathering and not for commercial use. (2) Affiliated with an educational or noncommercial scientific institution, and this request is made for a scholarly or scientific purpose and not for a commercial use. (3) Affiliated with private business and am seeking information for use in the company’s business. (4) An individual seeking information for personal use and not for a commercial use. I am willing to pay fees for this request up to a maximum of $ . If you estimate that the fees will exceed this limit, please inform me first. (NOTE: This statement is required even though assessable fees of $15.00 or less are automatically waived.) (Optional) I request a fee waiver because disclosure of the information is in the public interest. It is likely to contribute significantly to the public understanding of the operations and activities - 2 - of the and is not primarily in my commercial interest (include details about how the information will be disseminated by you to the general public.) (If the record sought is subject to contain any third party personal information which is protected by the Privacy Act of 1974, include the following statement in your request. “I agree to accept the requested records with all Privacy Act protected information redacted.” However, with such an agreement in your request the information redacted by your authority will not be considered a denial on our part. Therefore, you will not be given any appeal rights for that information.) Please contact me at (include area code and phone number) if you need to discuss my request further. Sincerely, __________________________________