Name (first, last e.g. John Doe)
Phone No.
E-mail Address
Organization
Address Line 1
Address Line 2
City
State
Zip Code
Province / Region / Territory
Post Code
Country
Requester Control No. (if applicable)
YOUR REQUEST:
STEP 1: IDENTIFY YOUR NEED FOR EXPEDITED PROCESSING
Select the item(s) below, as applicable and complete• COMPELLING NEED
Please explain why the value of the information will expire if not provided on an expedited basis.
• COMPELLING NEED
Please explain how the information has a particular value that will be lost if not processed on an expedited basis, such as a breaking story of general public interest. Information of historical interest only, or information sought for litigation or commercial activities, would not qualify as "urgently needed", nor would a news media publication or broadcast deadline unrelated to the news-breaking nature of the information.
• OTHER
Please provide a description of the due process rights that would be lost if the information is not provided with 10 calendar days. Note: If approved, this type of request may be processed in the expedited track behind those requests qualifying for compelling need.
STEP 2: CERTIFICATION
Should it be necessary, upon evaluating your request, that complex research and extensive consultation efforts will result, please indicate the fees you would be willing to pay for below.
You are required to select at least one of the choices below.
STEP 3: Privacy Act Request Instructions
If you are seeking records on yourself or your minor child(ren) (under 18), you must select the following declaration attesting to your identity:
"I declare under penalty of perjury that I am
