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:


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

    This field is not part of the form submission.

44. Submit

* indicates a required field