PARMA HEIGHTS POLICE DEPARTMENT
PUBLIC RECORDS REQUEST
Date of Request: _______________________
I, ___________________________________/Phone: ____________________________
desire to obtain a copy of a Parma Heights Police Department report relating to the
following incidents:
1. Incident involves a: Traffic Accident ( ), Crime ( ), Other ( )_______________
2. Description of the Record Requested (be specific):_________________________
_____________________________________________________________________
_____________________________________________________________________
3. Date of Incident:____________________________________________________
4. Location of Incident:_________________________________________________
5. Report/Log Number(s):
Signature and Badge of Officer/Dispatcher releasing the copy: _____________________
YOU ARE NOT REQUIRED TO COMPLETE THIS FORM
YOU ARE NOT REQUIRED TO IDENTIFY YOURSELF
For Department Use Only
Date of Completion: _____________ Cost of Report: $_____________
Receipt #:____________________ Date Distributed: _____________
Redactions:
____________________________________________________________________
Clear
Submit