Request for Police Report

2. Request Copy of Police Report
4. First Name*
5. Last Name*
7. Business Name
9. Address 1*
11. Address 2
13. City*
14. State*
15. Zip*
17. Phone Number*
18. Email Address*
20. Drivers License/State ID Number*
    List State and ID Number
22. Police Report Date*
    Police Report Date
    Select the date of the police report.
23. Police Report Number
    Enter the police report number, if known.
25. I request the following records are made available to me:*
    Please describe the type of police report (i.e. vehicle accident, stealing, etc.). If you do not have a police report number, please be as specific as possible regarding the incident.
27. I request that records responsive to my request be provided in the following manner:*

    1. I will pick up the documents
    2. Please email documents to the above email address
    3. Please mail documents to the above address
29. Maximum fee amount:*
    Enter the maximum amount you are willing to pay without prior notice for research and/or copying of requested records.
31. Signature of person making the request*
    The City will respond to this request within three (3) working days.
33. Do you agree?*

    By clicking "I agree," you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your "electronic signature" is valid and binding upon you to the same force and effect as a handwritten signature.

    1. I Agree
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit Submit and Print

* indicates a required field