FOIA RequestPPD FRM-507 1 of 2
PLEASE PRINT LEGIBLY
PLAINFIELD POLICE DEPARTMENT
14300 S. COIL PLUS DR.
PLAINFIELD, IL 60544 (815) 436-6544 Fax: (815) 436-1486
FREEDOM OF INFORMATION REQUEST
* * * PHOTO ID REQUIRED * * *
NAME BUSINESS (IF APPLICABLE)
ADDRESS CITY STATE ZIP CODE
Cell or Other Telephone Number EMAIL
Pursuant to the Freedom of Information Act, Chapter 5 ILCS 140, I request: a copy of to view only
This request for Plainfield Police Department public records is intended for commercial purposes: commercial
Description of Requested Records-(Please be specific on what you are requesting):
TYPE / NATURE OF THE INCIDENT
INCIDENT DATE INCIDENT TIME INCIDENT LOCATION
PERSONS INVOLVED:
OTHER INFORMATION: Preference: E-Mail Fax Pick-up Mail
FEE SCHEDULE:
No fees will be charged for the first fifty (50) pages of black and white, letter or legal sized copies of requested records. Fees for black and white copies in excess of fifty (50) pages, color copies, photo sheets, document certification, and other media are listed on the reverse side.
REQUESTOR’ SIGNATURE DATE
Your FOIA request will be processed within five (5) BUSINESS days after receipt of your request (21 days for
commercial purpose records requests) and you will be notified by telephone when your request is complete. If
we are able to honor your request, you may pick up your information at the Police Department Records
window between 7:00 a.m. and 5:00 p.m. Monday through Friday.
* * * DO NOT WRITE BEYOND THIS POINT * * * POLICE DEPARTMENT USE ONLY * * *
Photo ID shown and Copied If Request Was Faxed, A Copy Of The Photo Id Was Included
DEPARTMENT STAMP
RECEIVED BY: _
Fax
Email
PPD FRM-507 2 of 2
FOIA OFFICER ASSIGNED: Supervisor Approval: DATE FOIA REQUEST IS DUE (DATE OF RECEIPT PLUS FIVE (5) Business Days)
Approved by Village Prosecutor on Pending Court Cases: ICM Check-Case is Closed
Pursuant to 5 ILCS 140, Sec 3 (e) Subsection: i ii iii iv v vi vii
we are unable to supply the requested records at this time. The records will be made available to you in five (5)
business days on:
Entire Request Provided Partial Request Provided Entire Request Denied Cancelled by Requestor
Information has been redacted or denied in accordance with 5 ILCS 140, Sec 7-1:
Paragraph a; Juvenile Court, Act 705 ILCS 405
Paragraph a; All other Information Prohibited by State and Federal Laws.
Paragraph b; Private Information
Paragraph c; Unwarranted Invasion of Personal Privacy
Paragraph d; Law Enforcement; Subsection: i ii iii iv v vi vii
Paragraph e; Department of Corrections or County Jail
Other:
ADDITIONAL COMMENTS
NOTICE OF REVIEW PROCESS: Per 5 ILCS 140, Sec 9.5(a), you may request a review of an FOIA denial by the Public
Access Counselor within 60 days of the denial. The request must be made in writing, signed by you, and include a copy
of the FOIA request and our response. Mail your request for review to: Public Access Counselor, Public Access Bureau,
500 S. 2nd St., Springfield IL 62706. Their telephone number is 877-299-3642, email: publicaccess@atg.state.il.us
FOIA OFFICER’S SIGNATURE DATE
DOCUMENTS PROVIDED QTY COST EACH SUB-TOTAL
8½ x 11 Black and White copies, per side (First 50) NO CHARGE
8½ x 11 Black and White copies, per side (over 50) $0.15
8½ x 14 Black and White copies, per side (over 50) $0.15
11 x 17 Black and White copies, per side (over 50) $0.25
8½ x 11 Color copies, per side (any amount) $0.25
8½ x 14 Color copies, per side (any amount) $0.30
11 x 17 Color copies, per side (any amount) $0.35
Certification, per document $3.00
3 x 5 Photos $1.00
8 ½ x 11 Photo Sheets $2.00
Audio Tape (each tape) $4.00
CD (each CD) $3.00
DVD (each DVD) $5.00
Video Tape (each tape) NOTE: Requestor provides sealed video tape $5.00
Crash Reports – Standard (Fee charged per 625 ILCS 5/11-416) $5.00
Crash Reports – Reconstructed $20.00
TOTAL DUE:
Requestor Notified Date, Time, and Method of First Contact: Second Contact: Date, Time and Method of Contact:
Reports Mailed/Emailed
Denial Mailed/Emailed
Date Mailed/Emailed: Requestor Failed to Pick Up Request after Second
Notification
Date Refiled
Requestor’s Signature: Date Picked Up: Record Technician: