FOIA Requester Service Center [or FOIA Officer] Name
DoD Component Name
Address
City, State, Zip Code


Dear :

     This is a request under the Freedom of Information Act (5 U.S.C. § 552).

     I request that a copy of the following document(s) be provided to me: [identify the documents as specifically as possible].

     In order to help you determine my status for the purpose of assessing fees, you should know that I am [insert one of the descriptions below]

        a representative of the news media affiliated with the _______ newspaper (magazine, television station, etc.), and this request is made as part of news gathering and not for a commercial use.

        affiliated with an educational or noncommercial scientific institution, and this request is made for a scholarly or scientific purpose and not for a commercial use.

        affiliated with a private business and am seeking information for use in the company’s business.

        an individual seeking information for personal use and not for a commercial use.

     I am willing to pay the appropriate fees for this request up to a maximum of $___. If you estimate that the fees will exceed this limit, please inform me first.

     I also include a telephone number at which I can be contacted if necessary to discuss any aspect of my request.

                                Sincerely,



                                Name
                                Address
                                City, State, Zip Code
                                Telephone number