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2. This form is for Public 911 records request only.

   Fees for reproduction of public records is as follows:

   • $1.00 per page for pages 1-25
   • $0.50 per page for pages 26-500
   • $0.25 per page for pages 501+
   • $10 per audio record request of any archived file requested via email
   • $20 per set of DVD’s (two CD's are sent for legal discovery purposes)

   An additional $4.75 will be charged for postage.

4. Requester*
5. Organization
7. Email Address*
8. Phone Number*
10. Address
12. City
13. State
14. Zip Code
16. Date and Time of Call*
    Date and Time of Call*

    Date and Time of Call*
18. Call Description*
    Please describe the events that the request references.
20. Location of Incident*
21. Agency That Worked Incident*
23. AGENCY REPORT NUMBER*
24. PLEASE UPLOAD A COPY OF THE AGENCY REPORT TO EXPEDITE REQUEST
26. Requested Media

    1. Court certified CD
    2. Email that is not certified copy of request
    3. Both
    4. Printout Only
    5. Printout Only via EMAIL
27. Is a print out of the Computer-Aided Dispatch Report requested with the times and notes of the call?

    1. Yes
    2. No
28. Requested Physical Media Delivery Method

    1. Via US Mail
    2. Will pick-up
    3. Not Applicable
30. Additional Comments
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field