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West Allis Police Department Open Records Request Form

2. 

4. Please only fill out the sections you would like researched and fulfilled. Fees will apply per page.

   Please only fill out the sections you would like researched and fulfilled. Fees will apply per page.

6. Date
   Date

8. Email Address:*

10. Full Name (First, Middle Initial, Last) & Agency (if applicable):

11. Date of Birth:
    Date of Birth:

13. Address:

15. City:

16. State:

17. Zip Code:

19. Phone number

20. Phone type
    -- Select One --Home phoneBusiness phonePersonal phone

22. REPORTS REQUESTED

24. Date of Report:
    Date of Report:

25. Report Number(s):

26. Report Type(s):

28. Location(s):

30. Individual(s) Involved:

32. Other Information:

34. RECORDS CHECK ON PERSON - Complete this section ONLY if a background check is needed on a person

36. Person's Full Name (First, middle initial, last):

37. Person's Date of Birth:
    Person's Date of Birth:

39. Person's Address:

41. Person's City:

42. Person's State:

43. Person's Zip Code:

45. RECORD CHECK FOR CALLS OF SERVICE - Complete this section ONLY if an address check is needed

47. Location:

49. Dates:
    Dates: Start Date

    —

    Dates: End Date

51. * IT IS NOT MANDATORY THAT YOU PROVIDE YOUR NAME, HOWEVER, DOING SO ENABLES US TO PROCESS YOUR REQUEST AND PROVIDE THE INFORMATION TO YOU* REV 04/27/2017

    * IT IS NOT MANDATORY THAT YOU PROVIDE YOUR NAME, HOWEVER, DOING SO ENABLES US TO PROCESS YOUR REQUEST AND PROVIDE THE INFORMATION TO YOU* REV 04/27/2017

53. Request Approved
    -- Select One --YesNoLetter

54. Authority:

55. Amount Due:

57. Comments:

Leave This Blank:


59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit

* indicates a required field