Fillable Records Request Form Madison College Public Safety. List (Madison Area Technical College)

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Records Request Form Madison College Public Safety. List (Madison Area Technical College)

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File type: PDF

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Records Request Form
I, ____________________, am requesting the following records and documentation from
Madison College Public Safety.
List requested documents
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
I, _____________________, understand that due to ongoing investigations and
confidential information that all records may not be accessible and some documentation
may be withheld from records before being distributed to me.
_________________________________
Place State Photo ID Here
__________________________________
Once your request for records is submitted it will be reviewed by Madison College Public
Safety command staff and you will receive a response within 5 business days with the
decision whether the records may be released to you. Pending on the records you are
requesting there is no timeline as to when you will receive the requested records.
Requests are handled in the order in which they are received and are processed as timely
as possible. Any records request will be denied if a State photo ID is not present at the
time of request or if the information below is not filled out in its entirety. You will
receive a copy of this request upon submittal.
Requesters contact information
First____________________ M.I._________________ Last______________________
Street________________________ City ________________State___________
Phone___________________ Email____________________ DOB______________
Reason for Request of Records
________________________________________________________________________
________________________________________________________________________
Date of Request_______________ Signature of requester_________________________
Date Notified_________________ Means of Notification_______________________
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Records Request Form Madison College Public Safety. List (Madison Area Technical College)

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Completed 27 July 2020

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