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REQUEST TO INSPECT PUBLIC RECORDS Modesto Police Case Number Lobby Hours: Monday - Friday: 8:00 a.m. - 5:00 p.m. Records Phone: [PHONE REDACTED] Copy Cost: .10 cents per page + tax Photographs: $10 service charge *DO NOT use this form to request Juvenile Records* I request all records or documents concerning the incident described below for the following purpose (Check all that apply): Insurance Attorney Personal/Other (explain): Type of Record: Arrest Traffic Vandalism Burglary/Theft Domestic Violence Other Details of Incident: (Answer all that are applicable) Date/Time Reporting Requestor: Insurance Attorney Victim Traffic Injured Property Owner Arrested Other Claim/Court No. Business Phone Your Name: Date of Birth: Driver's License Residence Address: Phone No.: If the report needs approval before releasing, I will be notified within 10 days. (Initial DATE OF REQUEST: RECORDS USE ONLY: Accepted by: Date: Supervisor Review: Date: Picked Up: Date: Notified by Phone/ Mail (circle one) By: Date: Number of Pages Released: or PRA Letter Exempt 7923.605/7923.610 Exempt 7927.700 Submit to: [EMAIL REDACTED] Fax to: [PHONE REDACTED] Mail to: 600 10th St. Modesto, Ca. 95354 Attn: Records OR OR SIGN