Request for Police Report
A fee of $20.00 is charged for each single report copy. Log lis�ngs, sta�s�cal requests,
or reports requiring extensive search may cost more. Fees must be paid in advance.
Please provide iden�fica�on.
Requestor Informa�on (must be legible):
Name:__________________________________________________________________
Company: _______________________________________________________________
Address: ________________________________________________________________
City: _________________________ State: __________ Zip Code: ________________
Telephone Number: ____________________ Date of Birth: _______________________
Email Address: ___________________________________________________________
Relationship to report: Vic�m Suspect/Defendant Landlord
Other (Describe): ___________________________________________________
Reason for report request: __________________________________________________
Report Informa�on (must be legible):
Report Number (if known): 31-______________________________________________
Names and DOBs of involved par�es: _________________________________________
Nature: Accident D.U.I. Traffic Criminal Other: ___________________
Date(s): _______________________________ Time(s): __________________________
(Note: Cost of the report may increase if only the approximate date/�me is available)
Loca�on of Incident: ______________________________________________________
Inac�ve or stored reports may not be immediately available. They will be retrieved as
soon as possible and mailed to the address listed above. If this is not acceptable,
please list the date and �me that you will be available to pick up the requested
materials: ______________________________________________________________
Signature: ______________________________ Date: ___________________________
220 South Main Street · Newark, Delaware 19711
302.366.7100 · Fax 302.366.7115 · www.newarkde.gov
