Document Arvada_doc_13a2aadc4a

Rev (03/21) ARVADA POLICE DEPARTMENT Request for Police Information Due to the number of requests submitted, we are not able to process your request immediately Our goal is to complete all requests within 5 to 7 days. Fees are non-refundable. Please note that, in accordance with applicable law, the Arvada Police Department (APD) does not create new records upon request. As an example, the APD will not manipulate data contained in a police database in order to create a new record at the request of a member of the public. YOUR NAME YOUR DOB TODAY’S DATE CASE REPORT# (Leave blank if unknown) AGENCY/COMPANY YOU REPRESENT ADDRESS CITY STATE ZIP PHONE  CALL FOR PICKUP EMAIL ADDRESS  TO BE FAXED: MAIL TO:  SAME AS ABOVE  NAME: ADDRESS CITY STATE ZIP SECTION 1 REPORT • PHOTO • ADDRESS SEARCH REQUESTS REQUEST TYPE: □ Report $10 pre-paid report copy [Additional $.25/page over 10 pages. Redactions at additional cost of $.50/page] □ Photos $25 Digital Media □ Address Search $10 for 2 years: March 2016-March 2018 Extended search $20/hour Max search parameters May 2002 – March 2018 CONTACT TYPE: □ By Police Officer □ By Animal Control □ By Code Enforcement □ Online Submission REPORT TYPE: □ Traffic Accident □ Crime Report: □ Other: DATE OF INCIDENT TIME OF INCIDENT LOCATION OF INCIDENT or ADDRESS SEARCH PERSONS INVOLVED: Please provide names of all persons involved including date of birth (DOB) if known. YOUR RELATION IS REQUIRED. RELATION  Parent/Guardian  None RELATION  Parent/Guardian  None RELATION  Parent/Guardian  None RELATION  Parent/Guardian  None RELATION  Parent/Guardian  None SECTION 2 FOR CLEARANCE LETTER (RECORDS CHECK) $12.00 PER NAME RELATION  Parent/Guardian None  RELATION  Parent/Guardian None  I AFFIRM THAT THE CRIMINAL JUSTICE RECORDS OBTAINED FROM THE ARVADA POLICE DEPARTMENT UNDER THIS REQUEST WILL NOT BE USED FOR THE DIRECT SOLICITATION OF BUSINESS FOR PECUNIARY GAIN, AND ALSO AFFIRM THAT ANY BOOKING PHOTOGRAPHS OBTAINED UNDER THIS REQUEST WILL NOT BE PLACED IN A PUBLICATION OR POSTED TO A WEB SITE THAT REQUIRES THE PAYMENT OF A FEE OR OTHER EXCHANGE FOR PECUNIARY GAIN IN ORDER TO REMOVE OR DELETE THE BOOKING PHOTOGRAPH FROM THE PUBLICATION OR WEB SITE. SEE: C.R.S. § 24-72-305.5 DATE SIGNATURE BELOW FOR THE USE OF APD PERSONNEL ONLY REQUEST TAKER DATE AMOUNT RECEIVED $  CASH  CHECK  CREDIT CARD NOTES: REQUEST FILLER DATE  MAILED  EMAILED  FAXED  PICKUP  CALLED