Thomas H. Roberts & Associates, P.C.
Virginia's Civil Rights & Personal Injury Law Firm


(804) 783-2000









 

 

Sample FOIA request form for Virginia Government Employees in FLSA Action


cut and past into word processing 


Your Name
Your Address

                                                                                                May 24, 2005

Department of Transportation
Hanover County School Board
200 Berkley Street
Ashland , VA 23005
(804) 365-4500
(804) 365-4680 fax
 

RE:       Request under the Virginia Freedom of Information Act, §2.2-3700 et seq.
            Response due within 5 work-days of receipt.

            1st NOTICE:    Pursuant to §2.2-3714, any willful and knowing violation of §§2.2-3704, (Records open for Inspection), 2.2-3704, (Meetings)  2.2-3708  (Electronic Communication Meetings), 2.2-3711 (Executive or Closed Meetings) or §2.2-3712 (Call of Closed Meetings) shall result in a civil penalty against such individual in his individual capacity of not less than $100 nor more than $1,000.

            2nd NOTICE:    I have opted in to a proceeding under the FLSA.  This FOIA request seeks information that I may reference in my testimony in connection with the FLSA proceeding.  29 USC § 215(a) [I]t shall be unlawful for any person— (3) to discharge or in any other manner discriminate against any employee because such employee has filed any complaint or instituted or caused to be instituted any proceeding under or related to this chapter, or has testified or is about to testify in any such proceeding….

           3rd NOTICE:     The information requested herein is for the purpose of petitioning the government protected under the 1st and 14th Amendment of the United States      

Dear Sir/Madam:

            I am a citizen of Virginia .  In connection with testimony I am about to give in FLSA proceedings, the following records are requested to be produced to me within the time permitted under Virginia law:

1.         Any and all policies and procedures related to compliance with the Fair Labor Standards Act for the past three years.

2.         My complete personnel file.

3.         All time records for my time worked for the past three years.

4.         All records of additional bus runs and trips beyond my regular route.

5.         All notes, minutes and/or records of audits of my time for the past three years.

                                                                                    Very truly yours,

                                                                                    <your name>

Pc. Dr. Stewart D. Roberson, Superintendent of Schools
      Thomas H. Roberts, Esq.


 

 

Contact:

Thomas H. Roberts, Esq.
Thomas H. Roberts & Associates, P.C.
Virginia Civil Rights Attorneys
105 S. 1st Street
Richmond, Virginia 23219
804) 783-2000
804) 783-2105