Police Records Request Form - Scottsdale Police Department
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1Police Records Request Form
8401 E Indian School Rd
Scottsdale Public Safety Records
Scottsdale, AZ 85251
Phone: 480-312-1999
Information on this form will assist the Scottsdale Police Department in providing the public records you are requesting. You
need to provide sufficient information to specifically identify records, such as case number, incident location, and/or the date
of occurrence otherwise we may not be able to locate the requested records. Under Arizona law, some information not subject
to release may be removed or redacted from records prior to release.
Requestor's Information (Please print legibly)
First Name
Middle Name:
Last Name:
Home Address
City:
State:
ZIP:
Home Phone:
Work Phone:
Cell Phone:
Signature/Date:
Email Address:
These documents will be used for:
Accident Report Certification:
Non-commercial use. You are hereby notified that
"I certify I am an involved party, vehicle owner, or
conversion to commercial use is subject to civil penalties
insurance company, attorney, or private investigator
§
.
pursuant to A.R.S.
39-121.03
representing an involved party or owner for the
requested accident report."
Commercial use. I certify that these documents will be
If the above statement is true, initial here and indicate your
used for:
relationship to an involved party:__________________________
Items available for Request
Record of Search $10.00
Location or Event Dispatch History $5.00
Reports or associated materials
Report #:
Date of Birth:
Address:
Alternate Names (AKAs):
Copy of Report, $5
Social Security #:
Date Range:
Victim Copy of Report, no charge
OR
Photos, $5.00
Driver's License
Report #:
911 Recording, $16.50
State ID
Other, describe in box below.
Passport
Other:____________
If the Report Number is not known, please note all the information known, such as Name, DOB, Locations and/or Date and time of Event:
RECORDS USE ONLY
Date Processed:
Date Processed:
B#:
Date Released:
Cash Amt $__________________
Reason for Redaction:
B#:
Check # __________ $_________
Privacy/Confidentiality
Total
Number of Pages:
Statutory
Best Interests of Government
Release Notes:
SPD/FRM/PRR/revised 11/28/12
View Only
E-Mailed w/ follow up phone call
Mailed
Will Call Box
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