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The template asks for copies of all records the agency holds about the requester and provides identifying details such as full name, current address, birth date and place, and citizenship status. 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Box 39  \nVienna, VA 22183  \nRe: Freedom of Information Act & Privacy Act Request  \nDear [Disclosure Officer or Coordinator’s Name]:  \nThis is a request under the Freedom of Information Act, 5 U.S.C. § 552, and the Privacy Act, 5 U.S.C. § 552a, for copies of all records you have in your possession about me.  \nIn an effort to assist with your search for these records, I am providing the following additional information about myself:  \nFull name,  \nCurrent address,  \nDate and place of birth,  \nCitizenship status.  \n[Optional: Please explain contact, if any, with the Agency and any additional personal data you don’t mind revealing to the agency, such as other names used, former places of residence, foreign travel, government and other employment, political activities, etc., that would help us distinguish between you and other individuals with the same or similar names.]  \nIf you deny any or this entire request, please cite each specific exemption you feel justifies the refusal to release the information and notify me of appeal procedures available to me under the law.  \n[Optional: If you have any questions about handling this request, you may telephone me at (home phone) or at my (office phone).]  \nThank you for your consideration of my request.  \nSincerely,  \nName  \nAddress  \nCity, State, Zip Code  \nTelephone number [Optional]  \n(Individuals submitting a written request for access to their own records must agree to pay duplication costs, identify the System of Records to be searched, and provide a secondary identifier, e.g., certificate of identity, a date of birth or social security number.)","cbCaiuij502en8fD","https://ap.wps.com/l/cbCaiuij502en8fD","pdf",75648,"English","# Purpose of the Request\n## Records Requested\n## Requester Identifying Information\n## Denial and Appeal Instructions","[{\"question\":\"What records does the letter request?\",\"answer\":\"It requests copies of all records in the office’s possession about the requester.\"},{\"question\":\"Which personal details does the template suggest including to help the search?\",\"answer\":\"It suggests including full name, current address, date and place of birth, and citizenship status, with optional extra details to distinguish the requester.\"},{\"question\":\"What should happen if the request is denied?\",\"answer\":\"The letter asks that each specific exemption justifying refusal be cited and that available appeal procedures be provided under the law.\"}]","Sample Privacy Act Request Letter - Request for Records | PDF",1789516030]