P-2010-00967 INITIAL REQUEST

• Document Type: FOIA
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 05564703
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 2
• Document Creation Date: March 9, 2023
• Document Release Date: December 8, 2021
• Case Number: F-2011-02160
• Publication Date: August 4, 2010

Approved for Release: 2021/11/10 C05564703
p goio-a96-77
(b)(6)
July 26, 2010
Information and Privacy Coordinator
FOI/PA Request
Central Intelligence Agency
Washington, DC 20505
RE 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 (the Freedom
of Information Act, Title 5 United States Code (U.S.C.), Section 552; the Privacy Act, Title 5 U.S.C., Section
552a). Please process this request under both statutes to release all records. Please send all requested documents to the
following address (b)(6)
I request copy of all files, correspondence, memoranda, reports, electronic communications, all documents submitted by
me, all documents signed by me, all requests and disclosures made by the CIA and any other agencies, all records
reflecting contact with me, all records of investigation of me, and all other records concerning myself. To assist you with
this search I am providing the following information about myself:
DOE
POE
SSN
This is an individual request, and I agree pay up to $100 in fees, if necessary. Please notify me in advance if
fees are expected to exceed that amount.
If you have any questions or need any additional information, please do not hesitate to call me at the telephone number
above.
Under penalty of perjury (pursuant to Title 28 United States Code (U.S.C.), Section 1746), I hereby declare that I
am the person named above. I understand that any falsification of this statement is punishable under the provisions of
Title 18, 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 file on not more than $5,000.
(b)(6)
(b)(6)
Approved for Release: 2021/11/10 C05564703
(b)(6)
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Approved for Release: 2021/11/10 CO5564703
Information and Privacy Coordinator
FOI/PA Request
Central Intelligence Agency
Washington, DC 20505
Approved for Release: 2021/11/10 CO5564703