Name: _________________________________________________________________________
Title: _________________________________________________________________________
Address: _________________________________________________________________________
Email Address:
_________________________________________________________________________
7. This agency has determined that the records that you requested are not required to be made available
to the public based on the following [provide reason based on one or more exceptions appearing in
§87(2) of the Freedom of Information Law]:
Accordingly, your request is denied.
You have 30 days from receipt of a denial of access to records to appeal to:
Name: _________________________________________________________________________
Title: _________________________________________________________________________
Address: _________________________________________________________________________
Email Address:
_________________________________________________________________________
8. This agency has determined that it is unable to respond to your request at this time. Accordingly, on or
before [insert date within the next 20 business days] ________________, we will grant and/or deny
access in whole or in part.
9. This agency has determined that it is unable to respond to your request in full within the next twenty
business days for the following reasons [provide explanation as required by the Freedom of Information
Law, §89(3)]:
Accordingly, on or before [insert date] ____________________, we will provide and/or deny access in
whole or in part. Please advise by reply email if you would prefer that records be made available on a
piecemeal basis if it is feasible to do so.
10. Because the records you have requested include a list of names and residence addresses, disclosure
may constitute an unwarranted invasion of personal privacy pursuant to §89(2)(b)(iii) of the Freedom of
Information Law. If you maintain that such records are not sought for solicitation or fund-raising purposes,
as a condition precedent to disclosure, please prepare the following statement on a separate sheet of
paper, sign it, and mail it to the address indicated below.
I [insert name] ___________ certify that the requested list of names and addresses will not be used for
commercial or fund-raising purposes.
_________________________
[Signature]
Send to: _________________________________________________________________________
Name: _________________________________________________________________________
Title: _________________________________________________________________________
Mailing Address: ____________________________________________________________________