Information Request Form

This form should be used to request public records from MVRDA.

Requestor Details * denotes required field
First Name:	*
Last Name:	*
Agency Affiliation: (e.g. DASO, DA, LCPD, LCFD, if applicable)
Email Address:	*
Street Address:	*
City:	*
State:	* Zip: *
Telephone:	( ) - -
Delivery Method:	Postal Mail (postage fees additional) Pick Up E-Mail
Record Type and Reason
Records Requested :	Radio ($30.00 per CD) Telephone (9-1-1) Recordings ($30.00 per CD) Computer Aided Dispatch Printouts (50 ¢ per page)
Reason for Request:	*
Event Details Provide all available event details to aid the records team in locating the requested informatin.
CAD #:
Case #:
Date of Incident:	:
Location of Incident:
Type of Incident:	(No codes needed)
Officers Involved:
Complainant(s), Victim(s) Name:
Captcha:
If applicable: If CD is not picked up within one month of request, it will be destroyed and the $30 fee will be forfeited. All requests may require up to a two week lead time.

MVRDA