OWOSSO PUBLIC SCHOOLS FREEDOM OF INFORMATION ACT RESPONSE FOIA FEE FORM If payment is required as indicated in the accompanying guidelines and procedures, requested information will not be released until the payment described below is received. Please call the above Owosso Public Schools contact person indicated in the “Written you do not wish to receive this information. After 90 days it will be assumed that you no Procedures” or return this form if you decide longer require the requested documents. NOTE: This form will be utilized for calculating fees all labor costs will be calculated using – the rate (and associated benefit rate) of the lowest cost individual able to perform the function. REQUESTOR’S NAME AND ADDRESS: AMOUNT BILL CALCULATION LABOR (In increments of 15 minutes with time rounded down): Searching for and locating the material: 0.00 0.00 $ 0.00 No. of Hours: Wage Rate (including fringes) X Reviewing the material, including separating exempt from non-exempt material: 0.00 0.00 No. of Hours: Wage Rate (including fringes) X $ 0.00 POSTAGE: (Actual Cost of most economical and justifiable method for mailing) DUPLICATING: Labor: 0.00 0.00 $ 0.00 No. of Hours Wage Rate (including fringes) X Paper: $ .10 No. of Pages: Copying Rate per page X OTHER COSTS: Describe (e.g. Overtime, cost of audio tapes etc.) $ 0.00 Make check (business/personal) or money order payable to: Owosso Public Schools Mail Check/Money Order to: 645 Alger St. TOTAL P.O. Box 340 $ 0.00 Owosso, MI 48867 Return a Copy of this Invoice With Your Payment *PLEASE NOTE THAT IF A DEPOSIT IS REQUESTED, (TOTAL IS GREATER THAN DEPOSIT* $50.00), THE INDICATED AMOUNT IS AN ESTIMATE OF THE COST OF COMPLYING $ WITH YOUR REQUEST. THE ACTUAL COST MAY VARY FROM THIS AMOUNT. For Internal Use Only BALANCE TO BE PAID* Check / M.O. # REQUESTED INFORMATION TO BE: Provided without charge $ 0.00 Mailed upon receipt of payment From: Paid and picked up in person Date Payment Received: Date Documents Mailed: Date Documents Picked Up: Deposit payment in Agency Account Number: : Object Code:
OWOSSO PUBLIC SCHOOLS FREEDOM OF INFORMATION ACT RESPONSE FOIA FEE FORM If payment is required as indicated in the accompanying guidelines and procedures, requested information will not be released until the payment described below is received. Please call the above Owosso Public Schools contact person indicated in the “Written Procedures” or return this form if you decide you do not wish to receive this information. After 90 days it will be assumed that you no longer require the requested documents. NOTE: This form will be utilized for calculating fees – all labor costs will be calculated using the rate (and associated benefit rate) of the lowest cost individual able to perform the function. REQUESTOR’S NAME AND ADDRESS: BILL CALCULATION AMOUNT LABOR (In increments of 15 minutes with time rounded down): Searching for and locating the material: No. of Hours: 0.00 X Wage Rate (including fringes) 0.00 Reviewing the material, including separating exempt from non-exempt material: No. of Hours: 0.00 X Wage Rate (including fringes) 0.00 $ 0.00 POSTAGE: (Actual Cost of most economical and justifiable method for mailing) $ 0.00 DUPLICATING: Labor: No. of Hours 0.00 X Wage Rate (including fringes) 0.00 Paper: No. of Pages: X Copying Rate $ .10 per page $ 0.00 OTHER COSTS: Describe (e.g. Overtime, cost of audio tapes etc.) $ 0.00 Make check (business/personal) or money order payable to: Owosso Public Schools Mail Check/Money Order to: 645 Alger St. P.O. Box 340 Owosso, MI 48867 TOTAL $ 0.00 Return a Copy of this Invoice With Your Payment *PLEASE NOTE THAT IF A DEPOSIT IS REQUESTED, (TOTAL IS GREATER THAN $50.00), THE INDICATED AMOUNT IS AN ESTIMATE OF THE COST OF COMPLYING WITH YOUR REQUEST. THE ACTUAL COST MAY VARY FROM THIS AMOUNT. DEPOSIT* $ For Internal Use Only BALANCE TO BE PAID* $ 0.00 REQUESTED INFORMATION TO BE: Provided without charge Mailed upon receipt of payment Paid and picked up in person Check / M.O. # From: Date Payment Received: Date Documents Mailed: Date Documents Picked Up: Deposit payment in Agency Account Number: : Object Code:
FOIA%20fee%20form.docx