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FOIA Request Form

Note -Requests for personal information require a signature and cannot be processed through this online form. Instead, please follow the Privacy Act Request instructions (personal information includes, but is not limited to, information about current or former service members and employees of the Department of the Navy).

The following information is required by 5 U.S.C. 552, "Freedom of Information Act" as amended on 2 October 1996 and implemented by Navy Instruction 5720.42F dated 6 January 1999.

* Records you are Requesting

Dear FOIA Officer, This is a request filed under the Freedom of Information Act. I request:

* Description of Records

Describe the specific record(s) you seek with enough detail so that a knowledgeable official of the activity may locate the record with a reasonable amount of effort. Such detail should include descriptive information, time-frame to be searched, etc. Because most Navy records are not retained permanently, the more information provided, the better opportunity there is to determine if the records would still exist and where. The FOIA clearly states that records must exist at the time the request is submitted to be considered.

* Purpose of Request

In order to help to determine my status to assess fees, you should know that I am:

* Fee / Waiver

You must indicate your willingness to pay all fees or those up to a specified amount or provide a justification to support a fee waiver. Agreements to pay fees are considered to be up to $250, unless another amount is specified. Currently we charge search, review (for commercial requesters only), and duplication costs. The fee schedule is provided at enclosure (3) of SECNAVINST 5720.42F.

If you requested a fee waiver, please explain why you believe it is justified. Enter your justification in the text box:


Thank you for your consideration of my request.

How to Contact You

The following information is required by 5 U.S.C. 552, "Freedom of Information Act" as amended on 2 October 1996 and implemented by Navy Instruction 5720.42F dated 6 January 1999. Our form does not automatically collect your e-mail address. You must either include your e-mail address or a mailing address, if you wish to receive a response from us.

Please note: Before clicking the "submit" button, you should print the form and keep a copy for your records.

If the Internet is not functioning properly, send your request by fax to 717-605-2186.

Privacy Act Statement:

AUTHORITY: 5 U.S.C. 301, Departmental Regulations and 5 U.S.C. 552, Freedom of Information Act (FOIA).

PURPOSE: To allow individuals to file electronic FOIA requests; to track all FOIA requests from receipt to response to compile statistics for the Annual FOIA Report; to research and respond to FOIA requests; to maintain case files to comply with records disposal requirements; and to maintain an administrative record to support any litigation.

ROUTINE USE: Requests are received, assigned a case number, routed to the appropriate office or organization for research and response, and filed in a case file. Requests that are transferred, receive a no records response, or granted in full are retained for 2 years and then destroyed. Requests that are denied in whole or in part are retained for 6 years and then destroyed.

DISCLOSURE: Voluntary. We seek your full name and postal mailing address so we may mail a response to you. Failure to provide this information may result in your request not being processed (this page does not capture email addresses).

Information collected by this form is also used for trend analysis and may be shared with law enforcement personnel. Information submitted may be retained indefinitely.