Instructions Complete Freedom of Information Act Request Form

When completing the request, it is VERY important to be as SPECIFIC AS POSSIBLE. Your request may be delayed if you are not clear about the information you are seeking.

DATE OF REQUEST: Please use the date that you are completing the request.

NAME: Please provide the name of the person(s) or company that is requesting the information.

ADDRESS, CITY, STATE, & ZIP: Please provide us with your mailing address.

PHONE NUMBER: Please provide us with a daytime telephone number where you can be reached.

EMAIL ADDRESS: In the event that your FOIA can be emailed or you prefer email correspondence, please provide us with an email address.

INFORMATION REQUESTED: In general, South Carolina Freedom of Information Act requests are for documents Florence County Government has in its possession. Please be aware that not all information is subject to disclosure. Information of a personal nature (social security numbers, driver’s license number, etc.), information regarding juveniles (18 years and younger), and other specific information may be redacted.

Signature: Please sign your request indicating you have read the excerpt from §30-2-50.

Miscellaneous information: Pursuant to Freedom of Information Act Florence County will respond to a Freedom of Information Act request within 10 business days if the documents requested are two years old or less. If the documents requested are more than two years old, the response time is 20 days.

Florence County Council and Florence County Administrator’s Office is not the office of record for Elected and Appointed Officials.

To Request information from the Florence County Sheriff’s Office, go to www.fcso.org.

911 Tapes and/or Computer Aided Dispatch (CAD) Reports: To request information, complete the 911 Request form available on-line at www.fcemd.org .

For more information about the Freedom of Information Act, please visit http://www.scstatehouse.gov/code/t30c004.php

FLORENCE COUNTY

FREEDOM OF INFORMATION ACT

REQUEST FORM

Mail completed form to: Florence County Administrator’s Office, 180 N. Irby St. MSC-G, Florence, SC 29501

When completing the form below please print the requested information.

Date of Request: __________________________________

Name: __________________________________________

Address: ________________________________________

City: _________________State__________ Zip_________

Phone Number: ___________________ E-Mail Address: ___________________________

When completing the request, it is VERY important to be as SPECIFIC AS POSSIBLE. Your request may be delayed if you are not clear about the information you are seeking.

Information Requested/Detailed Description: ________________________________________________________

§30-2-50 prohibits a person or private entity from knowingly obtaining personal information from a local government or other political subdivision for commercial purposes. Violators are guilty of a misdemeanor and upon conviction are subject to a $500 fine and/or jail time up to one year. By signing below you are acknowledging that you have read the above statement regarding § 30-2-50.

Signature: ______________________________________

_____________________________________________________________________________________________

For Office Use Only:

Received: Hand-Delivered_____ Mail ____ Fax ____ E-Mail_______ by ____________________________

Request assigned to: ______________________ Date of Completion: _______________________

Date of Assignment: _________________________ Fee for Services Rendered: _________________

Comments: _____________________________ Method of Payment: ______________________

_____________________________________________________________________________________________

I have received______ pages in response to the Freedom of Information Act request above.

Signature: ____________________________________________________ Date_______________________

To View the South Carolina Freedom of Information Act in its entirety, go to http://www.scstatehouse.gov/code/t30c004.php