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Federal Bureau of Investigation
Records/Information Dissemination Section
170 Marcel Drive
Winchester, VA 22602-4843

Facsimile Number: (540) 868-4995

FREEDOM OF INFORMATION ACT REQUEST

Dear Sir or Madam:

This is a request for records under the provisions of the Freedom of Information Act.

I request copies of all records concerning the following individual or organization or subject: ________________________________________

(If for an individual) The individual's date of birth was: ____________________________

(If for an individual) I have enclosed proof of the individual's death such as an obituary, death notice, newspaper story, or encyclopedia (not wikipedia!) entry.

I believe that the following FBI file number(s) obtained from the National Archives / FBI "Exceptional Cases" list are responsive to my request: _________________________________

To be clear, I am requesting copies of the above files by file number and I am also requesting you to search your automated, manual, ELSUR, and "June Mail" indices for any other records that may pertain to my subject and thus be responsive to my request.

This is an individual request for research and study purposes. I agree that I will pay up to $30 for fees if necessary. Please notify me in advance if fees are expected to exceed that amount. If the response to this request is likely to result in more than 250 pages, I would like to receive an electronic copy of responsive records on a CD-ROM rather than paper copies. I understand there is a flat fee of $15 per CD-ROM with no per-page duplication fees.

If you have any questions, please call me at ______________

Thank you very much for processing this request.

Sincerely,

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