[Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] Federal Bureau of Investigation Attn: FOR/PA Request Record/Information Dissemination Section 170 Marcel Drive Winchester, VA 22602-4843 Subject: Request for FBI Files under the Freedom of Information/Privacy Act Dear Sir/Madam, I hope this letter finds you well. I am writing to request the release of my FBI files under the Freedom of Information/Privacy Act (FOIA), Title 5, United States Code, Section 552. I believe that the FBI may possess information about me and my activities, and I am eager to review these files for personal purposes. Furthermore, I am a resident of Alameda, California and have resided in this city for the past [X] years. My interactions with local law enforcement and the FBI may have generated relevant records that I am seeking to access. In order to conduct a thorough review of my records, I kindly request the disclosure of the following information, if applicable: 1. Incident/Case File Reports: Please provide any incident or case files that mention my name, aliases, or any associated identifiers. This includes files related to investigations, complaints, arrests, or any other engagements where my information was involved. 2. Surveillance Files: If there are any surveillance or monitoring activities conducted on me, whether by local or federal law enforcement agencies, I request the release of all materials and reports related to such surveillance, including video footage, audio recordings, photographs, or other relevant records. 3. Interviews/Witness Statements: If I have been interviewed or if my statements or testimonies were recorded by any FBI agents, I request copies of any related interviews, statements, or testimonies. 4. Correspondence: Please provide any letters, emails, memorandums, or other written communications referencing my name, aliases, or any associated identifiers. 5. Background Checks: If any background checks were conducted on me for employment, security clearances, or any other purposes, I request copies of these background investigations, including any reports or findings. I am aware that there may be exemptions to the information I am requesting, such as classified documents or information that pertains to ongoing investigations. However, I request that any redactions or exceptions be clearly communicated together with the released documents. To assist in identifying my records accurately and expediting the process, please find the information relevant to my request below: Full Name: [Your Full Name] Date of Birth: [Your Date of Birth] Social Security Number: [Your Social Security Number] Address at the time of incidents: [Previous Address, if applicable] Date range for requested records: [Specify the time frame, if known] I am willing to pay any reasonable fees associated with this request, but I kindly request that you inform me in advance if there will be any costs incurred. Please inform me of any additional steps or forms required to complete this request, and feel free to contact me if further information is necessary. Thank you for your attention to this matter. I look forward to receiving your response within the statutory timeframe of 20 working days, as outlined in the FOIA. Sincerely, [Your 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.