DATE OF REQUEST: ______/_______/_______
REPORT NUMBER: *SEE BELOW IF UNKNOWN___________________ OR Event Number: _____________________
TYPE OF INCIDENT: ○Traffic ○Burglary ○Auto Theft ○Assault ○Financial Crime ○Other: _______________
REQUESTOR: ○Victim ○ Attorney ○ Law Enforcement ○ Property Owner ○Other: ____________________
Please check: Is a juvenile involved in the report? ○YES ○NO
IF REPORT/EVENT NUMBER UNKNOWN:
PLEASE COMPLETE DETAILS OF INCIDENT BELOW
DATE/TIME OF INCIDENT: ___________________________________________________________________________
LOCATION/ADDRESS: _______________________________________________________________________________
NAMES OF REPORT PARTY/VICTIM/SUSPECT/DRIVER:
______________________________________________________________________________________________
PERSON REQUESTING REPORT PERSONAL INFORMATION
PRINT NAME: DATE OF BIRTH:
RESIDENCEADDRESS: DRIVER’S LICENSE/ID #:
CITY: ZIP: CONTACT PHONE: FAX:
IF THE REPORT IS NOT READY, HOW WOULD YOU LIKE TO RECEIVE YOUR COPY?
PLEASE CIRCLE:
FAX MAIL CALL FOR PICKUP
This agency has ten (10) business days to respond to the request from the date received in Records.
The report or notification of denial will be mailed.
________________________________________
SIGNATURE OF REQUESTOR
PLEASE REVIEW BEFORE COMPLETING YOUR REQUEST
If you are requesting a report by facsimile you must fax a copy of this request form
along with a copy of your picture identification to (209) 668-5642
TPD Use Only:
Date Received/By:______________________ Date Released/By:_______________________
Date Denied/By: / Comments: _________________________________________
TURLOCK POLICE DEPARTMENT
REPORT REQUEST
RECORDS - 244 N. BROADWAY
TURLOCK CA 95380
MONDAY - FRIDAY 9:00 A.M. - 5:00 P.M.
PHONE 209-668-5550 FAX 209-668-5642
