PUBLIC RECORDS (MEMBER AGENCIES)

THIS FORM IS TO BE USED TO REQUEST A COPY OF INFORMATION THAT HAS ALREADY BEEN REPORTED TO 911

Request Date (format: YYYY-MM-DD example: 2015-02-28)

Your Name

Phone

Mailing Address

Your Email

Audio for your request will be delivered in Wav File format via email. The CAD Event Chronology for your request is available via your user agency i/Netviewer connection therefore will not be provided by CENCOM unless requested.

Incident Date(s) (format: YYYY-MM-DD example: 2015-02-28)

Approximate Time

Caller(s) Name

Location of Incident

Agency Case No.

Officer's Name & No. (if known)

Suspects Name

Description of Incident

Other Information

Is this information needed for court? YesNo If yes, What is your Court Date? (format: YYYY-MM-DD example: 2015-02-28)

Please fill out as much information as possible. If more that one call is being requested for this incident, please identify under "Other information" the dates, phone number called from and appropriate time frames.

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