Freedom of Information Law Request for Records Requestor

CF-11 (Rev 02/18) Page 1 of 2

Freedom of Information Law

Request for Records

*This form is NOT intended for use as an appeal. Refer to the link below

for more information*

INSTRUCTIONS

• All requests must be made in writing. Please use this form to assist you in structuring your request

• Within five (5) business days this agency will respond to your request for records with a written acknowledgment of

receipt, and a statement of the approximate time frame required to respond to your request

• All applicable fees must be collected before any legally releasable record(s) are provided. Refer to our website for

more information at: https://troopers.ny.gov/foil-requests

• Submit completed form by email or mail to:

Email Address:

Mailing Address:

foilunit@troopers.ny.gov

or email submission, save this

completed form locally to your

computer and attach the saved copy

to your email*

New York State Police

Attn: Records Access Officer

1220 Washington Ave., Bldg. 22

Albany, NY 12226-2252

Requestor Information (Required)

Date (mm/dd/yyyy) Prefix Name (Last, First, MI) Suffix Phone #

Mailing Address City State Zip

Person You Represent (Last, First, MI)

Your Firm/Organization Name (if applicable) Phone #

Firm/Organization Address City State Zip

Record Information

*Identify or describe the government record(s) sought with detailed information to assist this agency in locating the record(s)*

Incident # (if available) Incident Type Incident Date (mm/dd/yyyy) Incident Time (am/pm)

Incident Location

Name of Involved Individual(s) (Last, First, MI) DOB (mm/dd/yyyy)