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Date
of Request___________________
Name of person making
request:_______________________________________________
Address:________________________________________________________________
Phone number where you can be
reached:______________________________________
Reason for
request:________________________________________________________
________________________________________________________________________
Date(s) of
Incident:___________________________________________________________________
______________________________________________________________________________________
Type(s) of
Incident:___________________________________________________________________
______________________________________________________________________________________
Location(s) of
Incident:_______________________________________________________________
______________________________________________________________________________________
Name(s) of People
Involved:__________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Deputy(s) who handled
report:________________________________________________________
______________________________________________________________________________________
*$5.00 charge per report
*Sheriff’s Office has 7 working
days to review and furnish a copy of the report.
(if it is within the criteria of the “Freedom of Information Act”)
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