2. Requester Information:
4. First Name:*
5. Last Name:*
7. Address:*
8. City:*
9. State:*
   -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
10. Zip Code:*
12. Daytime Phone Number:*
13. Email:
14. Fax Number
16. Describe the type(s) of document(s) you are requesting
18. Please describe specifically the documents you are requesting:*
20. How would you like to receive your copy?
    -- Select One --Paper (Pick-Up at IPD)EmailFax
21. Is this action solely for a commercial purpose?
    -- Select One --YesNo
23. Appeal:

    You have the right to file a written appeal to the Attorney General's Public Access Counselor within 60 days of receipt of the denial. The Public Access Counselor can be reached at 877-299-FOIA (3642) or public.access@ilag.gov. 

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29. Submit

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