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2. Police Dispatch Report Request Form
   Police Dispatch Reports can be difficult to locate with proper information provided by the caller and requester. It is essential for you to provide the exact date and the time within an hour of when the police were called. It is also essential for you to the exact address or location description (Business Name) where the police responded to. It is helpful for you to provide the name of the person that called the police unless they withheld that information from the police. Please spell all names, addresses and locations correctly.
4. Date and Time*
   Date and Time

   Date and Time
   Please provide the exact date and time within an hour of when the police were called.
5. Type of Call
   -- Select One --Assault / FightAccidentAlarmCriminal Mischief / VandalismCriminal TrespassersDomestic DisturbanceTheft Other

   Please choose the reason the Police were called.
7. Name
8. Email Address*
   Please provide the E-mail address you want the Police Dispatch Report sent to.
10. Address*
    Exact Address or Exact Location where the Criminal incident occurred.
12. City
13. State
14. Zip Code
16. Phone Number
    Phone Number of the Person that called for the Police
Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field