P-2010-00754 INITIAL REQUEST

• Document Type: FOIA
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 05537261
• 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: May 25, 2010

Approved for Release: 2021/12/07 C05537261
BERNSTEIN SHUR
COUNSES.05s ALAAW
May 18, 2010
Information and Privacy Coordinator
Central Intelligence Agency
Washington, D.C. 20505
Re:
Request for information�
Dear S r or Madam:
ScOc
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Roy W. Tilsley Jr.
rtilsleyOthernsteinshur.corn
This office represents Pursuant to the Freedom of Info
U.S.C. subsection 552 and the Privacy Act, 5 U.S.C. section 552a
author. zed me to request a summary of all rec9rds collected or he
Intelligence Agency regardin Jindexed to his name
not requesting copies of any records at this time. Rather,
ation Act, 5
as
confirmation of the quantity and nature of any documents indexed to
name, as well as an estimate of the amount of money expended by the CIA related to
th this letter is a certification of identity and representation executed by
nder penalty of perjury. If you deny all or any part of this request, please
cite each specific exemption that forms the basis of your refusal to release the
information and notify me of appeal procedures available under the law.
If you have any questions about handling this request, please contact me,
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Approved for Release: 2021/12/07 C05537261
Approved for Release: 2021/12/07 C05537261
Certification of Identification and Representation
Central Intelligence Agency to release
W. Titsley, Jr., Esq. at Bernstein Shur,
request, and pursuant to 32 CFR 1901.
do hereby authorize the
any and all information related to me to my attorney, Roy
P.O. Box 1120, Manchester, NH 03105. To facilitate this
13(a), I provide the following identification information.
Full name:
Citizenship Status
Social Security Number:
Current Address:
Date of Birth:
Place of Birth:
eclare under penalty of perjury under the laws of the
United States of America that the foregoing is true and correct, and that I am the person named
above, and I understand that any falsification of this statement is punishable under the provisions
of 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 provixions of 5 U.S.C. 552a(i)(3) by a fine of not more than $5,000.
Dated:
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Approved for Release
2021/12/07 C05537261
BERNSTEIN SHUR
COUNSELOR-SAT LAW
670 North Comm
Suite 108 PO Box MO
Mancheststs NH 031051120
Information and Privacy Coordinato
Central Intelligence Agency
Washington, D.C. 20505
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