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2. Requested By:
4. Name
5. Email Address
7. Address
9. City
10. State
11. Zip Code
13. Phone Number
14. Birthdate (If applicable)
15. Date Requested
17. Requester's Relationship to the Incident

    1. Complainant
    2. Suspect/Arrestee
    3. Property Manager

    1. Attorney/Insurance Company
    2. Other
19. if other, please specify
21. Incident Details
23. I am requesting data for:
    -- Select One --A specific incidentGeneral calls for service
24. Date(s)
26. Type of Incident
27. Case Number
29. Location/Address
31. Name of Subject Involved

    If different from above. You may need a signed release from the data subject. Without a signed release, you may not be entitled to the data requested.

32. Birth Date of the Subject Involved
34. Additional Information/Comments
36. Data Requested

    Check the data types you are requesting. The final cost will be calculated by office staff when the request is fulfilled.

38. Police Report

    1. Police Report delivered via email
    2. Police Report printed $0.25 /page
    3. Color Digital Photos $5.00 each
    4. 911 Audio File (only available to the subject of the data) $20.00
40. Report Options

    1. I want my report emailed to me
    2. I will pick up my report at City Hall
42. Important Information
    • Reports can be emailed free of charge providing there is no juvenile information contained in the report, and/or the report only contains public information.
    • Reports containing juvenile information can only be released to the involved juvenile's parent(s), in person. Identification must be provided at the time of the report's release.
    • There is a fee of .25 cents per page for hard copies of reports.
    • There is no fee for emailed reports.
    • All reports will either be mailed or ready for pickup within 10-business days of the request, or the date the report is complete, whichever is later. No exceptions.
44. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
46. Electronic Signature
Leave This Blank:


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

    This field is not part of the form submission.

50. Submit

* indicates a required field