Request For Access To Information Form - Scotland Police Page 4
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4RESTRICTED – WHEN COMPLETE
If you are authorising someone to act on your behalf, written confirmation of authority must be
enclosed. Solicitors must enclose a signed mandate. A copy of Power of Attorney should be
provided where appropriate.
WARNING. A person who impersonates or attempts to impersonate another commits an
offence.
THIS SECTION IS FOR OFFICIAL USE ONLY
To be completed by the Officer/Staff Member receiving this form
Application Checked and legible
Yes
No
Details of Identification Documents
Fee Paid
£
Method of Payment
Receipt Number
Details of member of staff accepting the form must be noted below
Name
PSI Number
Station/Department
Date
Signature
Please ensure that all details are complete prior to forwarding the application form within 48
hours, to the Information Management team at your former Force HQ
RESULT OF CHECK
Trace/No Trace
Signature
Date
RESTRICTED – WHEN COMPLETE
052-002
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V7-A3015
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