To: [FOIA office of the federal agency/component holding the records]
Date: [MM-DD-YYYY]
Subject: FOIA request for existing surveillance governance records
Under the Freedom of Information Act, 5 U.S.C. 552, I request electronic copies of these existing agency records for [start date] through [end date], concerning [identify program, technology or contract if known]:
1. Written operating policies, authorized-use rules, retention schedules and audit procedures effective during the period.
2. Executed equipment or data-service contracts, amendments, purchase orders and invoices for the identified program.
3. Existing executed data-sharing agreements and existing lists of authorized sharing partners.
4. Existing aggregate compliance or audit reports for [narrow date range].
These categories do not assert that the agency uses the technology or holds every record. Include responsive agency records maintained for the agency by a contractor for records management, where applicable. I seek existing governance and spending documents, not newly created analysis, individual movement histories, private investigative files or sensitive security details.
I prefer [format] if readily reproducible, delivered to [contact]. Please release reasonably segregable nonexempt portions and identify the legal basis and available review rights for any withholding. Please tell me if no responsive agency record is located.
My intended use is [describe truthfully]. Please identify the applicable requester fee category and schedule. Before assessable charges exceed [$ amount], please provide an itemized estimate and an opportunity to narrow the scope. This sample does not assert news-media or educational status, claim a waiver or authorize charges above that amount.
Please confirm receipt and provide the assigned tracking number and status contact as applicable. If an unusual-circumstances extension is invoked, please provide the reasons and expected determination date in writing.
Name: [Name]
Contact information: [Email or mailing arrangement]
Other information required by the agency's current rules: [Complete truthfully]