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This form is for public records from the University Police Dept. only. General University public records requests are handled through the University General Counsels office.

While it is not mandatory, completing this form will help us fill this public records request in a timely fashion.

Request Date: *

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Day

Name of Requester *

First

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Street Address of Requester: *

City, State, County, Zip Code: *

Telephone: *

Fax:

Email Address: *

Records Requested: *

Please identify each of the documents that are subject to this request with sufficient specificity so we can ascertain whether we have these documents and how to locate them.

Record Actions *

I would like to inspect the records

I would like the records copied to be picked up

I would like the records copied and mailed to the address listed on the form

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