Federal Bureau of Investigation
Attn: Initial Processing Operations Unit
Record/Information Dissemination Section
200 Constitution Drive
Winchester, VA 22602
Fax: (540) 868-4997
U. S. Department of State
Office of Information Programs and Services
2201 C Street N.W., Suite B266
Washington, D.C. 20520-0000
Central Intelligence Agency
Information and Privacy Coordinator
Central Intelligence Agency
Washington, D.C. 20505
U.S. Department of Homeland Security
Chief Privacy Officer/Chief FOIA Officer
The Privacy Office
245 Murray Lane SW [IH2]
Washington, D.C. 20528-0655
SENT BY EMAIL AND FEDERAL EXPRESS
Re: Freedom of Information Act Request
To the Freedom of Information Officer:
This is a request under the Freedom of Information Act, 5 U.S.C. § 552 ("FOIA"), and the Privacy Act, 5 U.S.C. § 552a, by My Name [IH3] to the Federal Bureau of Investigation (“FBI”), Central Intelligence Agency (“CIA”), Department of State(“State”), and the Department of Homeland Security (“DHS”)[IH4] for any and all records related to Ms. Name. Please refer this request to all appropriate subcomponents, offices, and other custodians within each agency.[IH5]
A. Personal Information
The following information should be used in identifying the records requested:
Full name: My Name
Other names by which Name has been known: My Full Name
Date of Birth: February 29, 1980
Place of Birth: New York City
Social Security Number: 123-456-7890
U.S. Passport # 1234567
Current address: 123 Activist Ave., Bronx, New York 11111[IH6]
Ms. Name also makes this request under the Privacy Act, 5 U.S.C. § 552a. Ms. Name consents to the disclosure pursuant to this request of personal information relating to herself. Appropriate forms signed by Ms. Name are attached to this request as Attachments 1-3. [IH7]
In 2005, Ms. Name received document productions in response to a similar FOIA request from DHS indicating the agency had her name on several lists of “known activists.” None of the records she received at that time indicated surveillance of her and her activities had ceased. Nor were those limited documents necessarily the extent of the records kept on Ms. Name during that period. Examples of the documents previously released to Ms. Name are attached to this request.
- Any RECORDS relating to investigations[IH11] conducted by any office, component or division, and/or individual agent(s), of the FBI, the CIA, the DHS or State that references or relates to My Name between January 1, 2021[IH12] and December 31, 2023;
- Any RECORDS of communication(s) between any person working for any component, office or division[IH13] of the FBI, CIA, DHS or State with any other U.S. government agencies, including state or local agencies, between January 1, 2021 and December 31, 2023, that references or relates to My Name
- Any RECORDS relating or referring to My Name, including, but not limited to, RECORDS that document any collection of information about, monitoring, surveillance, observation, questioning, interrogation or investigation [IH14] of My Name or her ACTIVITIES[IH15] ;
In addition, I ask that agencies prioritize the processing and production of any records relating to requests #4 - 12 below. Note that this should not preclude agencies from searching for the records specified in requests #1-3 of this FOIA request.[IH16]
- Any records or communications related to My Name’s ACTIVITIES in regards to Palestine, the Palestinian government, travel to or from Palestine, or anything else related, but not limited, to:
- Participation in the “Gaza Flotilla” in 2010.
- The delegation to Conference on Gaza in 2016.
- Any records or communications related to the June 1, 2018 March Against Trump, held in New York City, NY.
- Any records or communications related to Name’s work with and in support of the Movement for Black Lives from 2016-2019. This includes, but is not limited to:
- Records related to her involvement with MBL New York demonstrations organized in 2016.
With respect to the form of production, see 5 U.S.C. § 522(a)(3)(B). Please search for responsive records regardless of format, medium, or physical characteristics, and including electronic records. Please provide the requested document in the following format:
- Saved on a CD, CD-ROM, or DVD;
- In PDF or TIF format wherever possible;
- Electronically searchable text wherever possible;
- Each paper record in a separately saved file;
- “Parent-child” relationships maintained, meaning that the requestor must be able to identify the attachments with emails;
- Any data records in native format (i.e. Excel spreadsheets in Excel);
- Emails should include BCC and any other hidden fields;
- With any other metadata preserved.
I am entitled to a fee waiver pursuant to 5 U.S.C. § 552(a)(4)(A)(iii) on the grounds that "disclosure of the requested records is in the public interest because it is likely to contribute significantly to the public understanding of the activities or operations of the government and is not primarily in the commercial interest of the requester." 5 U.S.C. § 552(a)(4)(A)(iii). I meet the requirements for a fee waiver because the subject of the request concerns the operations or activities of the government, the disclosure of the information is likely to contribute to a significant public understanding of government operations or activities, the Requesters’ primary interest is in disclosure, and they have no commercial interest in the information. See 6 C.F.R. § 5.11(b); 22 C.F.R. § 121.16(a); 28 C.F.R. § 16.10(k); 32 CFR § 1900.13(b).[IH20]
I have spent the past 15 years dedicated to educating the public and advocating for civil rights and human rights, and have undertaken this work in the public interest and not for any private commercial interest. Similarly, the primary purpose of this FOIA request is to obtain information to further the public's understanding of how federal agencies have and continue to conduct surveillance of and their treatment of First Amendment-protected organizing. Access to this information is crucial for myself and my community partners, and will be used to evaluate government procedures and actions, as well as their potential detrimental effects.
I have no commercial interest in the requested information. [IH21] Disclosure in this case, therefore, meets the statutory criteria, and a fee waiver would fulfill Congress’ legislative intent in amending FOIA. See Judicial Watch Inc. v. Rossotti, 326 F.3d 1309,1312 (D.C. Cir. 2003) (“Congress amended FOIA to ensure that it be ‘liberally construed in favor of waivers of noncommercial requesters.’”)(citing McClellan Ecological Seepage Situation v. Carlucci, 835 F.2d 1282, 1284 (9th Cir. 1987)).
In the alternative, if no fee waiver is granted and the fees exceed $100.00[IH22] , please contact me to obtain consent to incur additional fees. Processing fees should be limited pursuant to 5 U.S.C. § 552(a)(4)(A)(ii)(II) (“[F]ees shall be limited to reasonable standard charges for document duplication when records are not sought for commercial use and the request is made by ... a representative of the news media.”).
I am entitled to expedited processing of this request because there is a “compelling need” for the information. 5 U.S.C. § 552(a)(6)(E)(i)(I). A “compelling need” is established when there exists an “urgency to inform the public about an actual or alleged Federal Government activity,” when the requester is a “person primarily engaged in disseminating information.” See 6 C.F.R. § 5.5(d)(ii); 32 CFR § 1900.34(a); 22 CFR § 171.11(f); 28 C.F.R. § 16.5(e)(ii).
In my work, I am significantly engaged in disseminating information and community advocacy in support of fundamental civil rights, and have a proven track-record of compiling and disseminating information and reports to the public about government functions and activities. [IH24] Furthermore, I will also disseminate any records released to the public for no cost as well.[IH25]
In addition, the agencies grant expedited processing where the subject of the request is a “matter of widespread and exceptional media interest in which there exist possible questions about the government's integrity that affect public confidence.” 28 C.F.R. § 16.5(e) (iv). As I, My Name, have continued my organizing efforts within social change movements, I am often called on as an expert to explain what the obstacles have been to securing policy changes from the federal government. It has often been difficult to understand how the actions of federal agencies, and more specifically agencies involved in policing, law enforcement and national security concerns have impacted on the internal workings of U.S. social movements. I have the right to know what federal agencies (as well as state and local agencies) have done in terms of monitoring my actions as an individual and as part of various organizations and projects. The sooner we obtain this information, the more not only myself but the individuals and organizations I work with can begin to have a fuller understanding of how these parts of the federal government have watched their activity and might have used information they obtained in ways that undermined their work.
I expect a determination of this request by each agency for records within 20 days, as provided by statute. See 5 U.S.C. § 552(a)(6)(A)(i).
If my request is denied, in whole or in part, I ask that each agency justify all deletions by reference to specific exemptions to FOIA. I also expect each agency to release all segregable portions of otherwise exempt material. I reserve the right to appeal each agency’s decision to withhold any information.[IH26]
Thank you for your prompt attention to this matter. Please furnish all applicable records to: My Name, at [email protected] (preferred) or by mail at My Name, My Address; (222) 222-2222. [IH27]
[email protected] (preferred)
 In past years, Ms. Name has also lived in North Carolina and Illinois.
 In this request the term “RECORD(S)” includes, but is not limited to, all Records or communications preserved in electronic (including metadata) or written form, such as correspondences, emails, documents, data, videotapes, audio tapes, faxes, files, guidance, guidelines, evaluations, instructions, analyses, memoranda, agreements, notes, orders, policies, procedures, legal opinions, protocols, reports, rules, talking points, technical manuals, technical specifications, training manuals, studies, or any other Record of any kind. Without limitation, the records requested include records at any stage of development, whether proposed, draft, pending, interim, final, or otherwise.
 Surveillance of Ms. Name and her activities by multiple federal agencies starting in the 1960s has been public information since 1978, when Ms. Name filed a FOIA request for similar materials and received several hundred pages of responsive documents, including documents from the FBI and the CIA. Attached as Attachments 4 and 5 to this FOIA request are brief examples from those previous releases from those agencies.
 The word “ACTIVITIES” as used herein includes, but is not limited to, any advocacy, provision of services, litigation, lobbying, organizing, fundraising, meetings, travel, conventions, or campaigns; and any media or communications to, from or about me in any form (including any oral, written, electronic or online communications, including but not limited to any books, pamphlets, brochures, newsletters, fundraising letters, correspondence, action alerts, e-mail, web communications, discussion groups, or listservs).
[IH5]If there are particular offices or components of an agency, such as the Office of Intelligence and Analysis within DHS, you can also ask that the request be specifically directed there.
[IH6]It is helpful to list this information out at the beginning of your request, since many agencies will need it to conduct their searches.
[IH7]Each federal agency will have its own “waiver form” that it will ask you to fill out and sign. Usually these are just one page. You can download these forms from each of the agencies’ websites.
[IH8]You can choose whether to include any additional background information or context here. Two reasons you might choose to include additional summary information:
First, you might be planning to do some public advocacy related to the filing of this FOIA request, so it might be helpful to provide a short narrative and possible some citations why this request is important, how it might be connected to broader organizing or movement activism, and some biographical information about yourself or about the person you’re filing on behalf of.
Second, as shown here, there might be some additional facts you want to make sure the government agencies are aware of. In this instance, previous FOIA records had been received and shown that surveillance had taken place. This is helpful so that agencies can’t simply deny the request and say there are no records of surveillance.
[IH9]This is the most important part of your request. You can choose to organize it however you think makes the most sense. Remember, like all FOIA requests, the more information you ask for, the longer it will probably take to receive.
The different requests included here are not mandatory for you to include – you should edit, delete, and add others that relate to what you’re looking for. These are just some general examples to get you started!
[IH10]Here, we would add a footnote describing out definition of "Records": "In this request the term “record(s)” includes, but is not limited to, all Records or communications preserved in electronic (including metadata) or written form, such as correspondences, emails, documents, data, videotapes, audio tapes, faxes, files, guidance, guidelines, evaluations, instructions, analyses, memoranda, agreements, notes, orders, policies, procedures, legal opinions, protocols, reports, rules, talking points, technical manuals, technical specifications, training manuals, studies, or any other Record of any kind.".
[IH11]Useful to ask for “investigative” records since investigations opened by agencies can often contain all types of records.
[IH12]Timeframes are important to include.
You can either include a timeframe for your entire request, or specific to certain parts. Remember, the bigger the timeframe, the more change for delay in the processing of your request. However, sometimes it’s important to include a large time frame if you believe you or your work has been surveilled for several years.
[IH13]Communications, such as emails, letters, memos and more, can be important in capturing informal mentions regarding records agencies might have kept on you. However, they can also slow down how quickly you receive records, so be specific if possible.
[IH14]This is some “catch-all” language that can be helpful in covering any types of records not already related to requests 1 and 2.
[IH15]We use “activities” here to define the different work that might result in surveillance. We have added a footnote with boilerplate language to that effect.
[IH16]In this request, we have organized more specific and priority requests related to certain events or campaigns in a separately from the more general requests 1-3. But remember that you can organize your own request however you like!
Please note that many of the events mentioned in this section are FICTIONAL.
[IH17]Always helpful to be specific that the records you’re requesting aren’t just for the day of the event but anything before and possibly after.
[IH18]As in all of our FOIA requests, it’s useful to specify how you want the records produced to you.
For individual requests, if it’s possible for you to make a short argument about how the records you’re requesting will be in the “public interest” you should do so. For example, you could say that records you get in response will provide transparency for other activists or people involved in similar work as your own.
[IH20]These citations are to the different FOIA regulations specific to each agency – FBI, DHS, CIA etc. You do not need to include them.
[IH22]You can make this amount any number you like, but this language will protect you from receiving a large bill for records an agency might process for you without letting you know the amount first.
[IH23]It can be helpful to request expedited processing. You can find out more about expedited processing in our FOIA guide.
For individual requests, a brief statement about the urgent need for the requested information and how it might apply to current circumstances and/or events is best for this section. If you’re able to cite to recent and related news articles or public testimony, that can be very helpful as well.
[IH24]Edit and use only if true. If you’re able to cite to publicly available information that shows that, that’s even better. For example, you could link to social media showing you have many thousands of followers who regularly show interest in your work, or a website where you’ve distributed other FOIA documents or relevant articles you’ve published.
[IH25]You don’t need to include this, but it can be helpful. It does not legally bind you to releasing all the information you get to the public, it simply shows that you intend to make any records you do release freely available.
[IH26]This is boilerplate language that we always include in our FOIA requests. It can especially be helpful if you later decide to litigate your FOIA request.
[IH27]Make sure you’re including contact information that you or someone you trust will be checking and have access to on a regular basis.