Freedom of Information
and Privacy Act Request
To:______________________________
_______________________________
_______________________________
This letter constitutes my formal request for information pursuant to
the provisions of the Freedom of Information and Privacy Acts, 5 USC
552.
I am requesting copies of all information maintained by your agency
that pertain to myself as described below:
Full Name:
Current Address:
Social Security No.:
Date and Place of Birth:
Former Addresses (use reverse if more space needed):
Date:____________ Signature:__________________________
I, __________________________ a Notary Public in and for the county
(city) and state of __________________________ hereby certify that
on the ____ day of _______, 19__, before me personally appeared
__________________________, who is known by me to be the identical
person whose name is subscribed to, and who signed and executed the
foregoing instrument. In witness thereof, I have hereunto set my hand
and official seal this day and year above.
My commission expires:____________ Signature of
Notary:___________________
INSTRUCTIONS
To find out if you have an FBI (or any federal agency) file and
obtain a copy of it, fill out the above information, have this form
notarized (you must sign it in front of a notary and provide the
notary sufficient identification), and mail to the FBI (or other
agency). A request should be sent to each field office that might
have files as well as FBI Headquarters. Make a copy of your signed
and notarized form for your records. Please note that it is a
criminal offense to represent yourself as another in attempt of
obtaining information.
THIS FORM IS A PUBLIC SERVICE OF GLEN L. ROBERTS
You are encouraged to copy this form and distribute to others. Glen
L. Roberts is editor of Full Disclosure. Glen L. Roberts, PO Box
1533, Oil City, PA 16301. Email: glr@ripco.com. Web:
http://pages.ripco.com:8080/~glr/glr.html
FBI
P O Box 366269
San Juan PR 00936
FBI
JFK Federal Bldg Rm 900
Boston MA 02203
FBI
150 Court St Fifth Fl
New Haven CT 06510
FBI
1 Gateway Market St 22nd Fl
Newark NJ 07101
FBI
26 Federal Plaza
New York NY 10278
FBI
James F Foley Bldg. 5th Fl
445 Broadway
Albany NY 12201
FBI
111 W Huron
Buffalo NY 14202
FBI
P O Box 1315
Pittsburgh PA 15213
FBI
William Green Bldg
Sixth & Arch St 8th Fl
Philadelphia PA 19106
FBI DC Field Office
1900 Half St SW
Washington DC 20305
FBI Headquarters
J Edgar Hoover Bldg
10th & Pennsylvania Ave
Washington DC 20535
FBI
7142 Ambassador Rd
Baltimore MD 21207
FBI
111 Green Court Rd
Richmond VA 23228
FBI
P O Box 3828
Norfolk VA 23514
FBI
6010 Kenley Ln
Charlotte NC 28217
FBI
Box 137
Columbia SC 29202
FBI
77 Forsyth St SW
Atlanta GA 30303
FBI
220 E Bryan St
Savannah GA 31401
FBI
Box 8928
Jacksonville FL 32239
FBI
16320 NW 2nd Ave
Miami FL 33169
FBI
Box 172177
Tampa FL 33672
FBI
2121 Bldg #1400
Birmingham AL 35203
FBI
P O Box 2128
Mobile AL 36652
FBI
710 Locust St #600
Knoxville TN 37902
FBI
Clifford Davis Fed Bldg #841
167 N Main
Memphis TN 38103
FBI
100 W Capitol #1553
Jackson MS 39269
FBI
600 Martin Luther King Jr Pl
Louisville KY 40202
FBI
1240 E 9th Rm 3005
Cleveland OH 44199
FBI
Box 1277
Cincinnati OH 45201
FBI
Box 1186
Indianapolis IN 46206
FBI
P O Box 2118
Detroit MI 48231
FBI
Box 2058
Milwaukee WI 53201
FBI
111 Washington St #1100
Minneapolis MN 55401
FBI
P O Box 3007
Butte MT 59702
FBI
219 S Dearborn St #905
Chicago IL 60604
FBI
P O Box 3646
Springfield IL 62708
FBI
1520 Market #2704
Saint Louis MO 63103
FBI
811 Grand #300
Kansas City MO 64106
FBI
P O Box 541090
Omaha NE 68154
FBI
1250 Poydras #2200
New Orleans LA 70113
FBI
P O Box 21470
Little Rock AR 72221
FBI
P O Box 54511
Oklahoma City OK 73154
FBI
1801 N Lamar #300
Dallas TX 75202
FBI
2500 E T.C. Jester
Houston TX 77008
FBI
Box 1630
San Antonio TX 78296
FBI
7000 E San Antonio #C600
El Paso TX 79901
FBI
P O Box 1229
Denver CO 80201
FBI
125 S State #3203
Salt Lake City UT 84138
FBI
201 E Indianola #400
Phoenix AZ 85012
FBI
301 Grand NE
Albuquerque NM 87102
FBI
700 8th Charleston Blvd
Las Vegas NV 89104
FBI
11000 Wilshire #1700
Los Angeles CA 90024
FBI
880 Front St #6S31
San Diego CA 92188
FBI
450 Golden Gate Ave
San Francisco CA 94102
FBI
P O Box 13130
Sacramento CA 95813
FBI
300 Ala Moana #4307
Honolulu HI 96850
FBI
P O Box 709
Portland OR 97207
FBI
915 2nd Ave #710
Seattle WA 98174
FBI
Box 100560
Anchorage AK 99510
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