Police Records Request Form

Police Department
310 Glenwood Avenue
(419) 599-2810

In the boxes below, please describe the specific public record you are requesting. Please understand your record request may be forwarded to the appropriate Department, Division, or person(s) with ready access to the record requested.

Date of Request Required

Americas/Detroit

Name

Mailing Address

Address 1

Address 2

City

Country

State/Province

Postal Code

Email Address Required

Media Type Requested Required

Paper ($0.05/page plus postage and delivery charge)

Electronic (no charge)

CD ($1.00/request)

Record to be... Required

Viewed (available for view at City Hall)

Emailed (no charge)

Mailed ($0.05/page + postage/delivery)

Faxed ($0.05/page)

Picked up ($0.05/page)

Specific Record requested - Please do NOT use this form for Public Record or Municipal Court Record requests Required

What is 9 + 10? Required