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