Under the provisions of Article 6, Sections 84 - 90, of the New York State Public Officers Law entitled, the FREEDOM OF INFORMATION LAW (FOIL), I hereby request the records or portions thereof that I have reasonably described in Part “B” of this form.

1. Name of Applicant:                                                                                                                                       

2. Company Name:                                                                                                                                           

3. Type of Business:

                         Government Entity

                         Law Firm

                         Other                                                                                                                                             

4. Address: ____________________ City:                  State: _______ Zip Code:                

5. Telephone Number: _________________________ Fax Number:                                                            

6. E-Mail:                                                                                                                                                            

Describe the records that you are requesting in the space provided below. Please include as much detail as possible such as the respective department having possession of the records, dates, titles, or any other information that may assist us in locating the record(s) you are seeking.

c I would like to schedule a time to review the records that I am requesting. I understand that access to the

requested records will be provided in accordance with Section 87 of New York State Public Officers Law. I

understand that copies may not be immediately available.

c I would like the requested documents mailed to me. I understand that access to the requested records will be

provided in accordance with Public Officers Law §87. I understand that any fees associated with my obtaining

copies of the requested records must be received by the City before the records are disclosed.

c I would like the requested records sent to the following e-mail address:                                                     

Should you desire copies of records, fees shall apply in accordance with Section 87(1) of the Public Officers Law. Advanced payment is required before records will be released.

FEES FOR PHOTOCOPIES: Pages up to 9” x 14”are $.25 ea. or the actual cost of reproducing any other record.

The fee for reproducing a record may include the actual cost of the storage device or media; actual cost for engaging outside professional service to reproduce record; hourly salary for employee time used in reproducing the record.

Please make check or money orders payable to the City of Buffalo Urban Renewal Agency.

After you have reasonably described the records you wish to inspect or obtain, please sign this form and return it to the City of Buffalo Urban Renewal Agency, BURA General Counsel, 920 City Hall, Buffalo, New York 14202. Requests may be sent via electronic mail, regular US mail, or hand delivery.

I hereby affirm that the information I have provided on this request form is correct.

Signature:                                                        Print Name:                                                   Date: