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COMPLAINT AUDIT REQEST.frm 9/27/17 CAYUGA COUNTY E-911 COMMUNICATIONS Public Safety Building 7445 County House Rd. Auburn, NY 13021 Denise A. Spingler, Administrator (315) 253-1191 [EMAIL REDACTED] FAX (315) 253-1192 CALL AUDIT REQUEST FORM ***NOTE: THIS FORM MUST BE FILLED OUT COMPLETELY, SIGNED BY THE HEAD OF THE AGENCY TODAY’S DATE SUBMITTED BY: DATE OF INCIDENT TIME OF INCIDENT: [ ] AM [ ] PM LOCATION OF THE (INCLUDE STREET ADDRESS (IF APPLICABLE) AND MUNICIPALITY) NATURE OF THE INCIDENT: . REASON FOR THIS REQUEST: SUBMITTING AGENCY: (AGENCY NAME IN PRINT) HEAD OF AGENCY: TITLE: (NAME IN PRINT) (TITLE IN PRINT) HEAD OF AGENCY: PHONE: (SIGNATURE) COMPLETED BY: DATE COMPLETED: DATE REC’D: TIME REC’D: DOCUMENTATION RECEIVED BY: [ ] CAD 9-1-1 CALL PRINTOUT [ ] AUDIO CD The audio files and/or documentation you received should be used for official purposes only. Duplication or modification of the materials is strictly prohibited.