Request for Release of Information Step 1 of 3 33% Type of Document Requested* Arrest Record Crime/Incident Report Other If Other, Explain Name of Person (Suspect/Victim/Other)* First Last Date of Birth* MM slash DD slash YYYY Report No./Booking No. Fill in this box if this information is known.Date of Occurrence* MM slash DD slash YYYY Time of Occurrence* : Hours Minutes AM PM AM/PM Address or Location of Incident* Street Address City State / Province / Region ZIP / Postal Code Type of Crime* Name of Requester and/or Agency* Phone Number*Fax NumberMailing Address* Street Address City State / Province / Region ZIP / Postal Code Driver License Upload* Drop files here or Select files Accepted file types: jpg, png, pdf, jpeg, Max. file size: 1 GB, Max. files: 2. Please upload the front and back of your Driver License. We accepted the following file formats: .jpg, .png, .pdf, jpeg. You are allowed to upload two files.Party of Interest* Person Involved - Victim, Reporting Party, Suspect Property Owner Authorized Individual - Written Authorization is Required Parent/Guardian of Juvenile Representative of Insurance Company or Insurance Adjusting Agency Attorney Other Party of Interest - Specify Below Please check one.Other Party of Interest CertificationI declare under the penalty of perjury that the selection below represents the party of interest identified in the record of requested hereon. I Am I Represent I Am An Attorney Signature*Date of Request* MM slash DD slash YYYY Contact Email* I declare under penalty of perjury, under the laws of the State of California, that the foregoing statements are true and correct. I agree EmailThis field is for validation purposes and should be left unchanged.
