Public Records Request Form

Please note: This application is considered to be public record.

For Police Department public records and reports Click here

To:

Subject:

Date:

Your Name
Address
City	State/Province Zip Code
Home telephone
E-mail

The following information is needed before a records search can be conducted for your information.

By completing this form, I hereby certify under penalty of perjury that the requested records will not be used for commercial purpose as defined in ARS § 39-121.03

The records will be used for commercial purposes.

If the record will be used for a commercial purpose, please state the purpose below:

I would like to:

Review the requested documents	Obtain photocopies of the requested documents (There is a charge of 20 cents per page for 8.5 x 11 photocopies) and $5.00 for each microfilm page.
Other format requested: Please specify type: Some records may be available in additional formats. You will be contacted .

Documents requested (please be as specific as possible):