Offense I Incident Report Request Form
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1OFFICE OF
Phil Camus, Constable Precinct 5
HARRIS COUNTY, TEXAS
OFFE NSE I INCIDENT REPORT REQUEST FORM
*DO N O T USE TO REQUEST VEHICLE ACCIDENT REPORTS!
I Incident Report, Calls for
Use this form to request a copy of an
Offense
Service or other information
ONLY.
Fill it
out,
with
specificity,
and
please write
legibly.
via
You may
send
your
request
fax,
regular
mail or email
to
the
following:
Harris County Constable Precinct
5:
ATTENTION: Terry Karliner
17423 Katy Freeway
Houston, Texas
77094
Fax:
281-492-3525
Email:
Theresa.Karliner@cn5.hctx.net
Today’s Date___________
OFFENSE/INCIDENT DETAILS
Please provide ALL of the following information applicable to your request:
/
Offense
Incident Report/Case
Number:
Information other than a Report (ie.: 24 Hour Notice, audio, video, Officer’s Return, etc.):___
Name(s)
of
Person(s), and Date of
Birth
(s),
Involved:
Exact Numbered Address of Offense / Incident:
I Incident:
Date or Date Range of
Offense
To expedite your request, please initial below:
______ I give permission for all information confidential by law to be redacted.
YOUR CONTACT
INFORMATION
Contact Name:
Contact Telephone
Number:
Fax Number:
_____________________________________________________________
Email
Address:
_________________________________________________________
Delivery
Address:
If we should need
additional
information
from you,
someone will
contact
you.
Once
your
requested information is
we will either contact you with
If
ready,
the
fee amount,
or
send responsive information
back
to
you.
you
need to
reach Terry
Karliner,
you may
contact
her
at 281-492-3562.
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