Sapd Form 133 - Police Report (Page 2 of 2) in pdf

Please fill out the below listed information, print clearly, and include as much information as possible to ensure this

request is processed efficiently:

1. Date of Request: _______________________________________________________________________________

2. Name of the Requestor: __________________________________________________________________________

3. Send the information to me by: Email / US Mail / I Will Pick Up (Circle One)

4. Requestor’s Email Address: _______________________________________________________________________

5. Requestor’s Address: ____________________________________________________________________________

City: _________________________________________________ State: ____________ Zip Code: _____________

6. Requestor’s Phone: _____________________________________________________________________________

7. Requestor’s Company Name (If Applicable):__________________________________________________________

8. I Want: an Offense Report / a Traffic Accident Report (Circle All that Apply)

9. SAPD Case Number: ___________________________________________________________________________

(This is usually provided by an SAPD Officer on a business card on the day of incident. Providing this

information will greatly expedite your request).

10. Date of the Incident: _____________________________________________________________________________

(This is mandatory for any records prior to the year 2005).

11. Approximate Time of the Incident: ____:____am/pm (Circle one)

12. Name and Date of Birth of Complainant, Victim or Drivers Involved: ______________________________________

______________________________________________________________________________________________

13. The Address, Block or Intersection of Where the Police were Dispatched to: ________________________________

______________________________________________________________________________________________

14. The Phone Number Used to Dial 911 (If Applicable):____________________________________________________

15. If the information you want is not listed as an option, please give a detailed description of the information that you

seek: _________________________________________________________________________________________

______________________________________________________________________________________________

SAPD FORM 133-FOIA Rev. (07-21-15)

Sapd Form 133 - Police Report Page 2