Report Request

2. 

3. Ardmore Police Department
   Email
   
   Records Division
   23 S. Washington
   Ardmore, OK 73401
   
   Ph: 580-223-1930
   Fx: 580-221-2518

4. Report Request

6. Date / Time of Request*
   Date / Time of Request

   Date / Time of Request

7. APD Report / Incident #

   Enter Report or Incident Number if known.

9. Date of Report / Incident*
   Date of Report / Incident Start Date

   —

   Date of Report / Incident End Date

   If exact date is unknown, please enter an approximate date range.

10. Location of Report / Incident*

    If exact location is unknown, enter at least the street name.

11. Nature of Report / Incident*

    (Examples: Accident, Disturbance, Theft, Property Damage, etc.)

13. Person the Report Involves*

14. Person's Date of Birth
    Person's Date of Birth

15. Sex*

    1. Male
    2. Female

17. Address*

18. City / State / Zip*

22. Requestor*

23. Phone #*

    In the event additional information is needed to locate the report, please enter a contact number.

25. Address*

26. Fax #

28. City / State / Zip*

29. Email*

    This agency is paperless. Enter an email address to receive the requested report. If no email address is available, enter a Fax number.

31. I request copies of the report described above. I affirm that the names, addresses, telephone numbers, and other information in this record shall not be used for the purpose of soliciting business for personal or financial gain.
    
    Signature*

32. Date*
    Date

34. ************************************************* FOR INTERNAL USE ONLY ***********************************************

36. Pages / Records Released

37. Comments

39. Custodian / Releasing Authority Signature

40. Date
    Date

Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field