Alsip FOIA RequestV2 (updated 04-08-2022)
FOIA FORM 3
VILLAGE OF ALSIP
NOTICE OF PROCEDURE FOR REQUESTING RECORDS
Requests for public records must be in writing and may be submitted on FOIA Form 3,
available at:
Village of Alsip
Clerk’s Office
4500 W. 123rd Street
Alsip, IL 60803
www.villageofalsip.org
Requests for records should be directed to:
Freedom of Information Officer, Renee N. Harding
c/o Clerks Office
4500 W. 123rd Street
Alsip, IL 60803
708.385.6902 (X2319)
foia@villageofalsip.org
No fees shall be charged for the first 50 pages of black and white, letter or legal sized copies
requested. After the first 50 pages, the fee for black and white, letter or legal sized copies shall
be 15¢ per page. Actual cost will be charged for other documents not of standard size and for
the recording medium (e.g. compact disk, tape, DVD). There is a fee of $1.00 for certification of
copies. The Village may waive or reduce fees if the person requesting the records states the
specific purpose for the request and indicates that a waiver or reduction of fees is in the public
interest.
Rev. 04/08/2022
CONTROL #_____________ FOIA FORM 3
VILLAGE OF ALSIP
REQUEST TO INSPECT AND/OR COPY RECORDS
Date: _____________
To: Freedom of Information Officer/ Renee N. Harding
c/o Clerk’s Office
4500 W. 123rd Street
Alsip, IL 60803
708.385.6902 (X2319)
foia@villageofalsip.org
I hereby request to inspect copy * the following records:
(Please describe requested records as specifically as possible, attaching additional page if necessary.)
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
_______________________________________________________________________________________
There is no copying fee for the first 50 black and white standard-sized copies. The fee for additional copies is 15¢
per page. Actual cost will be charged for copies of documents not of standard size, and for the recording medium
(e.g, compact disk, tape, DVD), when applicable. There is a $1.00 fee for certification of copies.
Is this request for a commercial purpose? Yes No
Are you requesting a waiver or reduction of copying fees? Yes No
If yes, what is the purpose of this request? ________________________________________________________
___________________________________________________________________________________________
_________________________________
Requester’s (Printed) Name
_________________________________
Requester’s Signature
Address:______________________________________
Phone Number_________________________________
Name of Business_______________________________
DO NOT WRITE IN THIS SPACE
___________________________________
DATE RECEIVED BY VILLAGE OF ALSIP
BY_________________________________
RESPONSE DUE ____________________
NOTIFIED BY PHONE____ MAIL_____
DATE____/____/ ____
Village of Alsip
Directory of FOIA Officers
Effective May 11, 2021
Renee N. Harding ‐ Village Clerk