INFORMATION REQUEST FORM
Date of Request _________________________
Incident # _________________________ Date of Incident _____________________
What information are you requesting? ______________________________________
TRAVIS COUNTY FIRE MARSHAL’ S OFFICE
Tony Callaway, FIRE MARSHAL
P.
O. BOX 1748, AUSTIN, TEXAS 78767
(512) 854-4621,
FAX (512) 854-6471
Address of Incident ______________________________________________________
Investigator (if known) ______________________________
Requestor:
Name _____________________________ ______________________________
(print) (signature)
Address ____________________________________________
Company ___________________________________________
Phone Number ______________________________________
Type of Fire:
_____ Residence
_____Vehicle
_____ Other (please specify) __________________________
When the report is ready, how would you like to receive the report?
_____ Call for pickup
_____ Email (email address: _______________________________)
_____ Fax (fax number: ___________________________________)
_____ Mail to: ___________________________________________
Please note that the report may be excepted from public disclosure under the Texas Public Information Act. As such, the
requested information may be sent to the Texas Attorney General’s Office for review. If so, you will be notified and given
the opportunity to respond.
IMPORTANT: Submit this form by fax or mail.
You may also print, scan, and email the signed form to fire.marshal@traviscountytx.gov.
