[Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] Federal Bureau of Investigation Records Management Division 170 Marcel Drive Winchester, VA 22602-4843 Dear Sir/Madam, Subject: Request for FBI Files pursuant to the Freedom of Information Act (FOIA) I am writing to request copies of my FBI files in accordance with the Freedom of Information Act (FOIA), 5 U.S.C. § 552. As an Iowa resident, I kindly ask you to provide me with the necessary documentation outlining any records or information the FBI may have about me. To assist you in processing my request efficiently, I am providing the following information: 1. Full Name: [Your full legal name, including any aliases or previous names] 2. Date of Birth: [Your date of birth] 3. Social Security Number: [Your Social Security Number — optional, but might expedite the process] 4. Address History: [Provide a detailed list of all addresses you have resided at, including street address, city, state, and ZIP code, chronological order from the present to as far back as possible] 5. Telephone Numbers: [List all telephone numbers associated with you, including home, work, mobile, and any other relevant numbers] 6. Email Addresses: [Include all email addresses that you have used, both personal and professional] 7. A Brief Description of the Records Requested: [Specify the specific records or information you are seeking, such as investigations, background checks, correspondence, or any other relevant details you wish to obtain] 8. Pertinent Timeframe: [Indicate the specific timeframe or date range that you believe the records might cover, if applicable] 9. Files Names or Identifiers: [If you are aware of specific file names, numbers, or other identifiers associated with your request, please include them here] 10. Fee Waiver Request: [If you believe that the requested records are in the public interest and the disclosure does not primarily benefit you personally, you may request a fee waiver. Clearly explain the reasons for your request.] I understand that there may be fees associated with processing this request. Please inform me in advance of any applicable costs that may be associated with obtaining these records, and kindly provide me with an opportunity to review and approve any expenditures before they are incurred. If you are unable to fulfill this request for any reason, or if additional information is required, please contact me using the provided email or telephone number. I appreciate your prompt attention to this matter. Thank you for your consideration and assistance. Sincerely, [Your Full Name]
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.