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2. Records Request Form
   Note: This form is not for reporting incidents. This form is only for requesting copies of previous reports.
4. Date and Time of Incident*
   Date and Time of Incident

   Date and Time of Incident
5. Accident / Incident Number
7. Type of Report Requested*

   1. Accident
   2. Incident
   3. Aduio / Video
8. Location of Accident / Incident*
10. Person Requesting Information
11. Contact Phone Number
13. Fax Number
14. Your Email Address*
16. Preferred Method of Receiving Report*

    1. In person
    2. Email
    3. Fax
18. Reason for Request
    Not required unless record is typically not considered public.
Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field