Electronic FOIA (E-FOIA) Request Form

To make an Electronic FOIA (E-FOIA) request, please provide the information below. Failure to enter accurate and complete information may affect the Census Bureau's ability to fulfill your request.

Requests submitted under the Privacy Act, (i.e. personnel records) must be signed and, therefore, cannot be submitted on this form.

Privacy Act statement

(*) Indicates a required field.

1. Contact Information

* Your Name:

Company/Association:

* Mailing Address:

(Maximum characters: 300)

Phone:

Fax:

E-mail:

* 2. Description of Records Requested:

Be as specific as possible about the records you are requesting. (NOTE: The FOIA does not require agencies to create new records; therefore, please be sure you are requesting existing records.)

Include information such as the subject matter and date and any other information that will help us search for documents.

CAUTION: Please do not submit sensitive information, such as your Social Security Number, date of birth, or any other personally identifiable information (PII).

(Maximum characters: 12,600)

* 3. Fee Provisions:

Select the amount you agree to reimburse the Agency for fees incurred to process your request. Refer to the FOIA Reference Guide for complete details.

$25

Up to

We will contact you if the estimated costs will exceed your authorized amount.

Yes, I am requesting a fee waiver. If checked, you will be required to provide justification for your fee waiver request.

In certain limited circumstances, individual requests are entitled to a fee waiver. The following factors must be met:

If you wish to request a fee waiver include the following sections in your request:

A clear statement whether subject of the requested records concerns "the operations or activities of the government."
Whether the disclosure is "likely to contribute" to an understanding of government operations or activities.
The contribution to an understanding of the subject by the public is likely to result from disclosure: Whether disclosure of the requested information will contribute to "public understanding.
The significance of the contribution to public understanding: Whether the disclosure is likely to contribute "significantly" to public understanding of government operations or activities.
The existence and magnitude of a commercial interest: Whether the requester has a commercial interest that would be furthered by the requested disclosure.
The primary interest in disclosure

Please provide your justification for requesting a fee waiver.

CAUTION: Please do not submit sensitive information, such as your Social Security Number, date of birth, or any other personally identifiable information (PII).

(Maximum characters: 6,300)

4. Expedited Processing:

Yes, I am requesting expedited processing.

You may be entitled to an expedited response of less than 20 days.

A FOIA request may receive "expedited" treatment in cases where:

there is a threat to someone's life or physical safety;

the requestor is primarily engaged in disseminating information and has established that the request is urgently needed to inform the public concerning some actual or alleged government activity;

where an individual will suffer the loss of substantial due process rights if the records are not processed on an expedited basis.

Please provide your justification for requesting expedited processing.

CAUTION: Please do not submit sensitive information, such as your Social Security Number, date of birth, or any other personally identifiable information (PII).

(Maximum characters: 6,300)

Freedom of Information Act (FOIA) Office