|Submitted||Nov. 7, 2014|
To Whom It May Concern:
This is a request under the Freedom of Information Act. I hereby request the following records:
I would like a copy of any document pertaining to me from the Federal Bureau of Investigation.
Dear Mr. Gold,
The FBI has received your Freedom of Information Act/Privacy (FOIPA) request. Before we can process your request you must complete and submit the U. S. Department of Justice (Certification of Identity) Form DOJ-361. Privacy Act requests (records about yourself); requires an original and legible signature, and the “penalty of perjury statement” which is included on the Form DOJ-361.
If you do not wish to use the Form DOJ-361, your request must be accompanied by a notarized signature or a statement signed under penalty of perjury stating that you are the person that you say you are. The statement should be above your signature and state, “I declare under penalty of perjury that the foregoing is true and correct. Executed on [date].”
The Form DOJ-361 is available at http://www.fbi.gov/ under the Freedom of Information Act/Privacy link, or http://www.fbi.gov/foia/. The form may be mailed or faxed to the FBI at the address/number below. A scanned copy is acceptable if sent by electronic means but the FBI does not accept electronic signatures. You may submit an attachment listing additional information that may aid in locating responsive records. Please place your name and contact information on the attachment.
If you are requesting a copy or wish to challenge your Criminal History Summary Check which is often referred to as a criminal arrest record aka (Rap Sheet) or a Criminal Background Check, please contact the FBI’s Criminal Justice Information Services Division (CJIS) at (304) 625-2000 or write to: FBI, CJIS Division, Attention: Record Request, 1000 Custer Hollow Road, Clarksburg, WV 26306.
If you require additional assistance please contact me.
Public Information Officer/GIS
Record/Information Dissemination Section (RIDS)
FBI-Records Management Division
170 Marcel Drive, Winchester, VA 22602-4843
PIO: (540) 868-4593
Direct: (540) 868-4286
Fax: (540) 868-4391/4997
A fix is required to perfect the request.