Request For Public Record Form - Walker Police Department
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1WALKER POLICE DEPARTMENT
REQUEST FOR PUBLIC RECORD
Date:____________________________
I request the right to:
(
) Inspect
(
) Make a memorandum, abstract or handwritten copy
(
) Receive a photocopy of the record
Describe precisely the exact records(s) or document(s) requesting. The Walker Police
Department will not respond to vague, unclear or overly-broad requests. Include
Report number (if known), date, location, person(s) involved, etc.
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
I agree to pay appropriate charges for copies as allowed by law and City regulation.
($2.00 for the first page and $1.00 per additional page is charged by this Department).
As provided by law, this Agency has five (5) business days to respond to your
request, and may request a 10 day extension if such is deemed necessary.
_______________________________
___________________________________________
Signature
Print Name
__________________________________________
Address
__________________________________________
City, State, Zip
__________________________________________
(Phone)
Office Use Only
(
) Approved
By ___________________________________
(
) Not Approved
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