Form Center

Request for Records

2. Case Number

   If Applicable

3. Date
   Date Start Date

   —

   Date End Date

5. Victim Name

6. Date of Birth
   Date of Birth

8. Complainant’s Name

10. Incident Address

    No P.O. Boxes

12. City

13. State

14. Zip

16. Identify the Records You Seek*

    Accident Report, Call for Service, Etc. To allow us to expedite your request, please be as specific as possible when describing the records you are seeking (time, date, names of individuals involved). If you cannot identify a specific record, you should clearly explain the type of records you are seeking from what time-frame and what subject matter the records should contain.

18. The requesting person is liable for any further dissemination of information contained in the report.

    The requesting person is liable for any further dissemination of information contained in the report.

20. First Name*

21. Last Name

23. Phone*

24. Email Address

26. Mailing Address

28. Address2

30. City

31. State

32. Zip

34. Processing Fees Breakdown
    <ul><li>Report (FOAA) 1-7 pages: $12 (each additional page after 7: $1)</li><li>Routine accident reports: $12</li><li>Color photos on printed paper: $2 each</li><li>Nonpaper requests (VHS,DVD,CD, Audiotapes): $25 each media form</li></ul>

    • Report (FOAA) 1-7 pages: $12 (each additional page after 7: $1)
    • Routine accident reports: $12
    • Color photos on printed paper: $2 each
    • Nonpaper requests (VHS,DVD,CD, Audiotapes): $25 each media form

36. Payment must received before a report can be released, unless other satisfactory arrangements have been made with the records clerk.
    <ul><li>Processing Time: 7-10 Business Days</li><li>Payments:<BR>Cash<br>Checks - Made to the Cumberland County Sheriff’s Office</li><li>Payment Due at Time of Pick-Up or Prior to Mailing</li><li>Available Pick-up Times: Monday - Friday: 8 a.m. - 4 p.m</li><li>Closed All Major Holidays</li></ul>

    • Processing Time: 7-10 Business Days
    • Payments:
      Cash
      Checks - Made to the Cumberland County Sheriff’s Office
    • Payment Due at Time of Pick-Up or Prior to Mailing
    • Available Pick-up Times: Monday - Friday: 8 a.m. - 4 p.m
    • Closed All Major Holidays

38. Please Note
    Some reports may not be available at the time of this request.

    Some reports may not be available at the time of this request.

40. Office Use Only

42. Paid

    1. Yes
    2. No

43. Receipt Number

44. Payment Method

Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit Submit and Print

* indicates a required field