Minneapolis Police Department Accident Report Request Form
Category 4: Legal counsel of any person described in Categories 1, 2 or 3.
Category 5: A representative of the insurer of any person described in Categories
1,
2 or 3.
State Claimant Name(s) and Claim(s) Number:
By signing below, I certify that the information and statements on this Accident
Report Request Form are true and correct. I understand that disclosing any
information contained in any accident report, except as provided in Minnesota
Statutes, Sections 169.09, subd. 13 and 13.82, subds. 3 or 6, or other statutes, is
a misdemeanor.
Signature of Authorized Requester
: Date:________________
•
Requests will not be processed without a signature from an authorized
requester
•
Checks and Money Orders can be made payable to the City of Minneapolis
•
Pre-paid accounts are available for high volume requesters
R
eports can be obtained in person or by mail at:
Minneapolis Police Records Information Unit,
350 S. 5
th
Street, City Hall Room 31
Minneapolis, Minnesota 55415.
For questions, call (612) 673- 2961.
For office use only:
Comments: Search made – No Report Made Operator initials:
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