Freedom Of Information Act Request Form

Freedom of Information Act Request Form

Date: ___________________________________

Name: ________________________________________________________________

Address: ______________________________________________________________

______________________________________________________________________

Phone Number: _______________________

E-mail Address: ________________________

Be specific and provide as much detail as possible to ensure that Public

Records Requested:

Media Network (“PMN“) is able to identify the information being requested.

I would like the materials provided to me in the following way:

Mailed to the above address

Call above phone number and I will pick up the documents

Electronically to the following email address:

Please note that PMN has five (5) business days after the receipt of this request to process your

request.

FOIA Coordinator – Public Media Network

359 S. Kalamazoo Mall

Kalamazoo, MI 49007

Email:

29346811.1\109386-00001

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Parent category: Business