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2. Requesting Party*

   1. Calling Party
   2. Citizen
   3. Court System
   4. Defendant

   1. Defense
   2. DSS Agent
   3. EMS/Fire Agency
   4. Law Enforcement

   1. News Media
   2. Private
   3. Prosecution
   4. Other
4. Caller Name (If Known)
5. Incident Number (if Known)
7. Incident Location / Address (include city)*
9. Date of Request*
   Date of Request
10. Date Needed by
    Date Needed by
11. Incident Time & Date
    Incident Time & Date

    Incident Time & Date
12. Time Span
    Time Span Start Date

    —

    Time Span End Date
16. Type of Request*

    1. CAD Report (Most Popular)
    2. Phone Recording*
    3. Police / Fire / EMS Radio Recording*

    * Any audio (Radio or Phone) is ONLY maintained for approximately 30 days from date of call. Phone call information can ONLY be given out to the person who called 911 - NO exceptions! 

17. Duration of Radio Recording
    -- Select One --Dispatch OnlyUnder Control or Suspect in CustodyUntil Units Arrive

    When requesting a copy of radio traffic, please specify how far into the incident you need, i.e., Dispatch only; until units arrive on scene; until the incident is "under control" or suspect is in custody, etc.
19. Requested By - Name*
20. Phone*
22. Email*
24. Reason for Request*
26. I, the undersigned, understand that this is a copy of an original confidential tape, and certify that it will not be reproduced or used for reasons other than those documented by this authorization. I also am aware that all recordings will be sent electronically.
28. Signature*
29. Date*
    Date
Leave This Blank:


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

    This field is not part of the form submission.

35. Submit

* indicates a required field