Use this form to make an Electronic FOIA (E-FOIA) request (You may also use this form to make a Privacy Act request.) This form is voluntary, but if you choose to submit a request, you must provide the information marked with an "v". If you do not enter accurate or required information, we may be unable to fulfill your FOIA request. To learn how we use the information you provide, please read our Privacy Policy.

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Contact Information:

Name: (First, MI, Last,) v

Address: v

City v

State v

Zip Code v

Daytime Area Code & Phone Number v

Fax

E-mail

Describe the type(s) of document(s) you are requesting: v

Enter Company name, address and any other information relevant to the request (See Tips)

Select a suitable description of yourself and the purpose of the request: v

A. An individual seeking information for personal use and not for commercial use. If the subject matter of your request is yourself, FTC staff may contact you to verity your identity.

B. Affiliated with an educational or noncommercial scientific institution, and this request is made for a scholarly or scientific purpose and not for commercial use.

Enter Educational or Scientific Institution name:

C. Affiliated with a private corporation or law firm and am seeking this information for use in the company's business.

Enter company/firm name:

D. A representative of the news media and this request is made as part of news gathering and not for commercial use.

Enter media company name:

The FOIA allows agencies to charge fees for processing FOIA requests (see fee schedule);

Enter the maximum cost amount
that you are willing to pay: v
None Up to $25 Up to $50 Up to $75 Up to $100 Contact me if above $100 Contact me if above $200