P-2010-01064 INITIAL REQUEST

• Document Type: FOIA
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 05578893
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 3
• Document Creation Date: March 9, 2023
• Document Release Date: December 8, 2021
• Case Number: F-2011-02160
• Publication Date: September 3, 2010

Get Mv FBI File-- Sten 7 of 7 Approved for Release: 2021/11/10 C05578893
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August 22, 2010
Information and Privacy Coordinator
Central Intelligence Agency
Washington, DC 20505
FREEDOM OF INFORMATION ACT! PRIVACY ACT REQUEST
Dear Sir or Madam:
This is a request for records under the provisions of the Freedom of Information Act and the Privacy Act. Please
process this request under both statutes to release the maximum number of records.
I request copies of all files, correspondence, or other records concerning myself. To assist you with this search I
am providing the following information about myself
Other names used:
My date of birth:
My place of birth
My Social Security number:
My citizenship:
I am enclosing a copy of my driver's license or other state-issued photo ID
This is an individual request for research and study purposes, and I agree that I will pay up to $30 for fees, if
necessary. Please notify me in advance if fees are expected to exceed that amount.
If you have any questions, please call me at
Under penalty of perjury, I hereby declare that I am the person named above and I understand that any falsification
of this statement is punishable under the provisions of Title 18, United States Code (U.S.C.), Section 1001 by a
fine of not more than $10,000 or by imprisonment of not more than five years, or both; and that requesting or
obtaining any record(s) under false pretenses is punishable under the provisions of Title 5, U.S.C., Section 552a(i)
(3) as a misdemeanor and by a fine of not more than $5,000.
Sincerely,
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Approved for Release: 2021/11/10 C05578893