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2. Freedom of Information Act
   We will use the information you provide to try and locate the requested information. 911 records are generally stored by address or phone number and not by names. If we have additional questions to find the requested information we will contact you. There is a minimal cost for the time and materials needed to provide the information.
4. REQUESTOR DETAILS
6. Requester's Name*
10. Date of Incident
    Date of Incident
    if known
11. Time of Incident
    Time of Incident
    if known
13. Incident Number
    if known
14. Incident Phone
    Phone number for phone used to report incident (if known)
16. Requester's Relationship to Incident*
    -- Select One --Involved PartyAttorney for Involved PartyInsurance Agency for Involved PartyMediaOther

    Please select an item from the list
20. Request Delivery Address
    where would you like us to send the information you are requesting?
22. Name
24. Mailing Address
26. City
27. State
28. Zip Code
30. Phone Number
32. Email address
    Email is preferred contact method
36. Instructions
    Please describe below the information you are requesting with as much detail as possible to ensure we provide you the correct information. If there is additional information not captured in the choices above (multiple dates, times, etc) please indicate that here.
38. Requested Information
    Please be as specific as possible
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field