Public Information Request Form

Citizen Request for Law Enforcement Records Only

2. Name

4. Address1

6. Address2

8. City

9. State

10. Zip

12. Preferred method(s) of contact for response:

    Be sure to enter the appropriate information in the next box.

    1. Phone
    2. Mail
    3. Email
    4. Fax
    5. I will check back
13. The date I will check back:

14. If no follow-up by requestor within 30 days, request is voided (by law).

16. Supply the contact information (Phone Number, Mailing Address, or Fax Number)

18. Reply Email: (this is your email address)

22. INFORMATION REQUESTED

23. What information are you wanting?

25. Are you looking for a:

    1. Public Copy (basic information)
    2. Full Copy (detailed information)
    3. Public AND Full Copy
    4. Calls for Service

27. Do you know the Report Number(s):

28. Date of Incident:

30. Include any additional information (including names and addresses) that would help us identify what you are asking for:

32. I agree to receiving a redacted copy of the requested documentation/information in order to expedite my request.

    1. yes
    2. no

34. Requestor:

35. Date:

39. Requests for offense reports only are usually provided at no cost. However, costs are incurred for the reproduction of other media types, and may include charges for labor, overhead, and other actual costs. SPD must provide the requestor with a written estimate of charges if the cost will exceed $40 before the requestor is obligated.

43. Should you require additional information, you have the right to make subsequent requests.

Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field