CITY OF GARDEN CITY
FOIA REQUEST FORM
PLEASE PRINT
Date: ____________________ Telephone Number: (
) _______________
Name: _________________________________________________________
Address: _______________________________________________________
Please describe the public record(s) as specifically as possible. If this is for the
Police Department, PLEASE be sure to include the report number and any other
pertinent information.
Signature of Requestor
Date
Staff Use Only:
Received By:
Date:
Referred To:
Date: