ࡱ > [ ! bjbj 7 ΐ ΐ 8 , H3 H3 @ @ CB CB CB WB WB WB 8 B KC WB D D -D -D -D \ > G\ [\ . Я X CB g\ [ ^ \ g\ g\ @ @ -D -D ~ D ;^ ;^ ;^ g\ v @ < -D CB -D ;^ g\ ;^ ;^ A | -D Pꄟ WB \ ? F } Z 0 ( ] ( ( CB g\ g\ ;^ g\ g\ g\ g\ g\ ;^ g\ g\ g\ g\ g\ g\ g\ ( g\ g\ g\ g\ g\ g\ g\ g\ g\ H3 Q? : Robinson Township, Ottawa County 12010 120th Ave Grand Haven, MI 49417 Phone: (616) 846-2210 FOIA Request for Public Records Michigan Freedom of Information Act, Public Act 442 of 1976, MCL 15.231, et seq. Request No.: __________ Date Received: ___________ Check if received via: E m a i l F a x O t h e r E l e c t r o n i c M e t h o d D a t e d e l i v e r e d t o j u n k / s p a m f o l d e r : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ( P l e a s e P r i n t o r T y p e ) D a t e d i s c o v e r e d i n j u n k / s p a m f o l d e r : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ N a m e P h o n e F i r m / O r g a n i z a t i o n F a x S t r e e t E m a i l C i t y S t a t e Z i p R e q u e s t f o r : C o p y C e r t i f i e d c o p y R e c o r d i n s p e c t i o n S u b s c r i p t i o n t o r e c o r d i s s u e d o n r e g u l a r b a s i s D e l i v e r y M e t h o d : W i l l p i c k u p W i l l m a k e o w n c o p i e s o n s i t e M a i l t o a d d r e s s a b o v e E m a i l t o a d d r e s s a b o v e D e l i v e r o n d i g i t a l m e d i a p r o v i d e d b y t h e t o w n s h i p : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ N o te: The township is not required to provide records in a digital format or on digital media if the township does not already have the technological capability to do so. Describe the public record(s) as specifically as possible. You may use this form or attach additional sheets: Consent to Non-Statutory Extension of Townships Response Time I have requested a copy of records or a subscription to records or the opportunity to inspect records, pursuant to the Michigan Freedom of Information Act, Public Act 442 of 1976, MCL 15.231, et seq. I understand that the township must respond to this request within five (5) business days after receiving it, and that response may include taking a 10-business day extension. However, I hereby agree and stipulate to extend the townships response time for this request until: ________________ (month, day, year).Requestors SignatureDateRecords Located on Website If the township directly or indirectly administers or maintains an official internet presence, any public records available to the general public on that internet site at the time the request is made are exempt from any labor charges to redact (separate exempt information from non-exempt information). If the FOIA coordinator knows or has reason to know that all or a portion of the requested information is available on its website, the township must notify the requestor in its written response that all or a portion of the requested information is available on its website. The written response, to the degree practicable in the specific instance, must include a specific webpage address where the requested information is available. On the detailed cost itemization form, the township must separate the requested public records that are available on its website from those that are not available on the website and must inform the requestor of the additional charge to receive copies of the public records that are available on its website. If the township has included the website address for a record in its written response to the requestor and the requestor thereafter stipulates that the public record be provided to him or her in a paper format or other form, including digital media, the township must provide the public records in the specified format (if the township has the technological capability) but may use a fringe benefit multiplier greater than the 50%, not to exceed the actual costs of providing the information in the specified format. Request for Copies/Duplication of Records on Township Website I hereby stipulate that, even if some or all of the records are located on a township website, I am requesting that the township make copies of those records on the website and deliver them to me in the format I have requested above. I understand that some FOIA fees may apply. Requestors SignatureDateOvertime Labor Costs Overtime wages shall not be included in the calculation of labor costs unless overtime is specifically stipulated by the requestor and clearly noted on the detailed cost itemiza t i o n f o r m . C o n s e n t t o O v e r t i m e L a b o r C o s t s I h e r e b y a g r e e a n d s t i p u l a t e t o t h e t o w n s h i p u s i n g o v e r t i m e w a g e s i n c a l c u l a t i n g t h e f o l l o w i n g l a b o r c o s t s a s i t e m i z e d i n t h e f o l l o w i n g c a t e g o r i e s : 1 . L a b o r t o c o p y / d u p l i c a t e 2 . L a b o r t o l o c a t e 3 a . L a b o r t o r e d a c t 3 b . C o n t r a c t l a b o r t o r e d a c t 6 b . L a b o r t o c o p y / d u p l i c a t e r e c o r d s a l r e a d y o n t o w n s h i p s w e b s i t e R e q u e s t o r s S i g n a t u r e D a t e R e q u e s t f o r D i s c o u n t : I n d i g e n c e A p u b l i c r e c o r d s e a r c h must be made and a copy of a public record must be furnished without charge for the first $20.00 of the fee for each request by an individual who is entitled to information under this act and who: 1) Submits an affidavit stating that the individual is indigent and receiving specific public assistance, OR 2) If not receiving public assistance, stating facts showing inability to pay the cost because of indigence. If a requestor is ineligible for the discount, the public body shall inform the requestor specifically of the reason for ineligibility in the public body's written response. An individual is ineligible for this fee reduction if ANY of the following apply: (i) The individual has previously received discounted copies of public records from the same public body twice during that calendar year, (ii) The individual requests the information in conjunction with outside parties who are offering or providing payment or other remuneration to the individual to make the request. A public body may require a state m e n t b y t h e r e q u e s t o r i n t h e a f f i d a v i t t h a t t h e r e q u e s t i s n o t b e i n g m a d e i n c o n j u n c t i o n w i t h o u t s i d e p a r t i e s i n e x c h a n g e f o r p a y m e n t o r o t h e r r e m u n e r a t i o n . 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