Central Dispatch FOIA Request Form

Please complete the following where applicable:

1. Name of Person Making Request

First Name *This question is required.

Last Name *This question is required.

Agency (if applicable)

Your Client (if applicable)

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

2. Contact Phone or Email (must provide at least one):

Phone (###-###-####):

Email: This question requires a valid email address.

3. Best way to contact you in case of questions or additional information needed

Please supply as much of the following information as possible so we may provide you with the most accurate records.

4. Name Referred to in Record

5. Date of Birth of person involved in incident (mm/dd/yyyy) This question requires a valid date format of MM/DD/YYYY.

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6. Complaint # (if known)

7. Arrest

Arresting Officer

Type of Arrest

8. Event

Date of Event (mm/dd/yyyy) This question requires a valid date format of MM/DD/YYYY.

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Time of Event (if known)

Location of Event (street/city/zip)

9. Caller

Caller's Name

Phone Number Called From

10. Summarize what information you are looking for (be very specific)