To find out if you have an FBI (or any federal agency) file and obtain a copy of it, fill out the information below, have this form notarized (you must sign it in front of a notary and provide the notary sufficient identification), and mail to the FBI (or other agency). A request should be sent to each field office that might have files as well as FBI Headquarters. Make a copy of your signed and notarized form for your records. Please note that it is a criminal offense to represent yourself as another in attempt of obtaining information.

Freedom of Information

and Privacy Act Request

To:______________________________

_______________________________

_______________________________

This letter constitutes my formal request for information pursuant to the provisions of the Freedom of Information and Privacy Acts, 5 USC 552. I am requesting copies of all information maintained by your agency

that pertain to myself as described below:

Full Name:

Current Address:

Social Security No.:

Date and Place of Birth:

Former Addresses (use reverse if more space needed):

Date:____________ Signature:__________________________

I, __________________________ a Notary Public in and for the county

(city) and state of __________________________ hereby certify that

on the ____ day of _______, 19__, before me personally appeared

__________________________, who is known by me to be the identical

person whose name is subscribed to, and who signed and executed the

foregoing instrument. In witness thereof, I have hereunto set my hand

and official seal this day and year above.

My commission expires:____________<N> Signature of

Notary:___________________

LIST OF ADDRESSES TO SEND TO:

FBI

P O Box 366269

San Juan PR 00936

FBI

JFK Federal Bldg Rm 900

Boston MA 02203

FBI

150 Court St Fifth Fl

New Haven CT 06510

FBI

1 Gateway Market St 22nd Fl

Newark NJ 07101

FBI

26 Federal Plaza

New York NY 10278

FBI

James F Foley Bldg. 5th Fl

445 Broadway

Albany NY 12201

FBI

111 W Huron

Buffalo NY 14202

FBI

P O Box 1315

Pittsburgh PA 15213

FBI

William Green Bldg

Sixth & Arch St 8th Fl

Philadelphia PA 19106

FBI DC Field Office

1900 Half St. SW

Washington DC 20305

<B>FBI Headquarters

<D> J Edgar Hoover Bldg

10th & Pennsylvania Ave

Washington DC 20535

FBI

7142 Ambassador Rd

Baltimore MD 21207

FBI

111 Green Court Rd

Richmond VA 23228

FBI

P O Box 3828

Norfolk VA 23514

FBI

6010 Kenley Ln

Charlotte NC 28217

FBI

Box 137

Columbia SC 29202

FBI

77 Forsyth St. SW

Atlanta GA 30303

FBI

220 E Bryan St.

Savannah GA 31401

FBI

Box 8928

Jacksonville FL 32239

FBI

16320 NW 2nd Ave

Miami FL 33169

FBI

Box 172177

Tampa FL 33672

FBI

2121 Bldg #1400

Birmingham AL 35203

FBI

P O Box 2128

Mobile AL 36652

FBI

710 Locust St. #600

Knoxville TN 37902

FBI

Clifford Davis Fed Bldg #841

167 N Main

Memphis TN 38103

FBI

100 W Capitol #1553

Jackson MS 39269

FBI

600 Martin Luther King Jr Pl

Louisville KY 40202

FBI

1240 E 9th Rm 3005

Cleveland OH 44199

FBI

Box 1277

Cincinnati OH 45201

FBI

Box 1186

Indianapolis IN 46206

FBI

P O Box 2118

Detroit MI 48231

FBI

Box 2058

Milwaukee WI 53201

FBI

111 Washington St. #1100

Minneapolis MN 55401

FBI

P O Box 3007

Butte MT 59702

FBI

219 S Dearborn St. #905

Chicago IL 60604

FBI

P O Box 3646

Springfield IL 62708

FBI

1520 Market #2704

Saint Louis MO 63103

FBI

811 Grand #300

Kansas City MO 64106

FBI

P O Box 541090

Omaha NE 68154

FBI

1250 Poydras #2200

New Orleans LA 70113

FBI

P O Box 21470

Little Rock AR 72221

FBI

P O Box 54511

Oklahoma City OK 73154

FBI

1801 N Lamar #300

Dallas TX 75202

FBI

2500 E T.C. Jester

Houston TX 77008

FBI

Box 1630

San Antonio TX 78296

FBI

7000 E San Antonio #C600

El Paso TX 79901

FBI

P O Box 1229

Denver CO 80201

FBI

125 S State #3203

Salt Lake City UT 84138

FBI

201 E Indianola #400

Phoenix AZ 85012

FBI

301 Grand NE

Albuquerque NM 87102

FBI

700 8th Charleston Blvd

Las Vegas NV 89104

FBI

11000 Wilshire #1700

Los Angeles CA 90024

FBI

880 Front St. #6S31

San Diego CA 92188

FBI

450 Golden Gate Ave

San Francisco CA 94102

FBI

P O Box 13130

Sacramento CA 95813

FBI

300 Ala Moana #4307

Honolulu HI 96850

FBI

P O Box 709

Portland OR 97207

FBI

915 2nd Ave #710

Seattle WA 98174

FBI

Box 100560

Anchorage AK 99510