Tennessee Open Records Request
*Please show Photo ID issued by governmental entity including customers’ address (example: driver’s license).
List form of identification provided:
(PLEASE PRINT ON THIS FORM)
*Today’s Date: ________________________________________________________________
Customer Information
*Full Name: ___________________________________________________________________
(First and Last Name)
*Mailing Address:______________________________________________________________
(No P.O. Box)
*City, State, Zip Code: _________________________________________________________
*Email Address (*): ____________________________________________________________
*Telephone or Cell Number: _____________________________________________________
*Driver License Number and State: _______________________________________________
*Date of Birth: ________________________________________________________________
*Type of Record(s) Requested: ___________________________________________________
(Incident Report, Arrest Report, Inspection Report, Documents from the City of Red Bank)
*If requesting an accident report, are you one of the following: ________________________
(Driver, Passenger, Insurer, Legal Representative)
*I agree that I will abide by the following language:
It is a Class A misdemeanor for any person to knowingly use the report or information
contained in the report for solicitation that is prohibited by a standard of conduct or
practice of any profession licensed by the state. X________________________________
*Report Number or Tracking Number(s): _________________________________________
(Example – Tracking Number #16-012345)
*Report Date: _________________________________________________________________
*Location: ____________________________________________________________________
(Business or Street Name)
*Victim(s) Name & Date of Birth: ________________________________________________
*Suspect(s) Name & Date of Birth: _______________________________________________
*Property Address: ____________________________________________________________
(For Inspection Reports Only)
*Preferred Method to Receive Records: ___________________________________________
***Charges for producing copies of Public Records are .15¢ (black and white copies) and .50¢
(color copies) per page. CD copies are $3.00 per disk.