Police Department Request For Public Records (Freedom of Access Act (FOAA))

2. Date of Request:*
   Date of Request:

4. **Name and Contact Information**
   You are not required to give us contact information, however, it will make it easier to contact you to arrange for an appointment to view the records and/or arrange for delivery of copied records.

   You are not required to give us contact information, however, it will make it easier to contact you to arrange for an appointment to view the records and/or arrange for delivery of copied records.

6. First Name

7. Middle Initial

8. Last Name

10. Telephone #*

11. Email Address:*

13. Address1

15. Address2

17. City

18. State

19. Zip

21. Records Requested
    To assist us with finding the record(s) you request, please fill out the information below.

    To assist us with finding the record(s) you request, please fill out the information below.

23. Date and Time of Incident:*
    Date and Time of Incident:

    Date and Time of Incident:

24. Parties Involved:*

    Description of the records requested (dispatch log, accident report, arrest report, incident report, etc.):

26. Would you like to:*

    1. Set an appointment to review records?
    2. Request a copy of the records?

Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

* indicates a required field