FOIL Request Form

(Freedom of Information Law Request Records Access)

Please complete the below form and submit online, or the linked form and mail.

Records Management Officer
Town of Southport
1139 Pennsylvania Avenue
Elmira, New York 14904

Under the provisions of the New York Freedom of Information Law, Article 6 of the Public Officers Law, I hereby request records or portions thereof pertaining to (attempt to identify the records in which your are interested as clearly as possible):

Request following records:

Choose from following

If any copying fees for records:

Contact Option please inform me before filling request
please supply records without informing me

As you know, the Freedom of Information Law requires that an agency respond to a request within five (5) business days of receipt of a request. Therefore, I would appreciate a response as soon as possible and look forward to hearing from you shortly.

If for any reason any portion of my request is denied, please inform me of the reasons for the denial in writing and provide the name and address of the person or body to whom an appeal should be made.

Sincerely,
First Name: Middle Name: Last Name: Suffix:

Address:
City: , State: Zipcode:

Date (use any valid date format):

Phone:

Email Address*:

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Town of Southport
1139 Pennsylvania Avenue, Elmira, NY 14904
(607) 734-1548 | townofsouthport.com