New York Codes, Rules and Regulations
Title 13 - DEPARTMENT OF LAW
Chapter VI - PUBLIC ACCESS TO DEPARTMENTAL RECORDS
Part 120 - PUBLIC ACCESS TO DEPARTMENTAL RECORDS
Section 120.10 - Requests for records

(a) Persons appearing in person to request access to records will be required to complete the following request form:

APPLICATION FOR PUBLIC ACCESS TO RECORDS

RECORDS ACCESS OFFICER

Name of Agency _ Request Number ___________________________________________________________

Address

I HEREBY APPLY TO INSPECT THE FOLLOWING RECORD:

_______________________________________________________

_______________________________________________________

_______________________________________________________

Name _ Representing _____________________________________

Mailing Address _ Telephone Number ___________________________________________________________

Signature _ Date _________________________________________

FOR AGENCY USE ONLY

APPROVED

DENIED (for the reason(s) checked below)

___Confidential Disclosure __ Part of Investigatory Files

___Unwarranted Invasion of Personal Privacy

___Record of Which This Agency is Legal Custodian Cannot Be Found

___Record is not Maintained by This Agency

___Exempted by Statute Other Than the Freedom of Information Act

___ Request has been Referred to Department Which has Custody or Control of Original Record

___ Other (specify) ___________________________________________

Signature

_______________________________________________________

Title

Date

NOTICE: YOU HAVE A RIGHT TO APPEAL A DENIAL OF THIS APPLICATION TO THE HEAD OF THIS AGENCY OR HIS DESIGNEE WHO IS:

Name _ Business Address __________________________________________________________

WHO MUST FULLY EXPLAIN HIS REASONS FOR SUCH DENIAL IN WRITING WITHIN SEVENWORKING DAYS OF RECEIPT OF AN APPEAL

I Hereby Appeal:

Signature _ Date _________________________________________

(b) Requests made orally or in a form other than authorized by this Part will not be entertained.

(c) Requests by mail will be processed at the location where received either by mail or by intra-departmental routing. Such requests will be processed if the requestor and material sought are sufficiently identified to make compliance practicable. In the absence of such identification, the department may send to the requestor a copy of the above form for completion in order that the request may be considered.