Audio File Request Form

Date of Request *

mm/dd/yyyy

Requestor Name *

First

Last

Requestor Organization/Affiliation (if any)

Requestor Address

Requestor Email *

Requestor Phone Number *

(###)###-####

Type of Audio Requested *

9-1-1 Call Audio
Radio / Dispatch Audio
CAD System Audio / Logs
Other

Other:

Incident / Case Number (if known)

Date of Incident / Call *

mm/dd/yyyy

Type CCJRA (if

Approximate Time of Call (start / end) *

Location / Address of Incident *

Agency / Division Involved

Explain Intended Use (e.g. media, legal defense, research) *

Affirmation (Required for Criminal Justice Records / CCJRA Requests) *

Agree

I hereby affirm that any records received will not e used for the direct solicitation of business for pecuniary gain, and will not be used in a manner prohibited by law.

Fee Acknowledgement *

Acknowledge (must be selected)
I request a fee waiver (if eligible under statute)

I understand that I may be charged fees associated with processing, redaction, reproduction,media, shipping. I will be informed of any fees before duplication or release.

Delivery Preference *

Other