Public Records Request
*
Mr.
Ms.
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First:
Middle:
*
Last:
Baytown Police PRR:
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Date of Birth:
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Daytime Phone:
(xxx-xxx-xxxx)
Cell or
Other Phone:
*
Mailing Address:
Suite/Apt.
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City:
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State:
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Zip:
*
Email Addr:
*
Re-Enter
Email Addr:
Preferred
Delivery Method:
Select One
Copy
Electronic
Inspect
Fax Number:
Police Department Information Request
Labels flagged with a
*
indicate a required field.
Case Number:
Incident Address:
Incident Date/Time:
Time:
AM
PM
Persons Involved:
*
Are you Requesting a copy of the Police Report?
Yes
No
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Documents Requested and Description of Incident
Also, please provide
date
,
time
and
location
of the incident, as well as any other information,
including names of persons involved:
(Please include as much detailed information as possible, as this will help us better serve you.)
Depending on the type of information you request, the cost for this item may exceed the
standard charge or may require a deposit.
WAIVER:
Do you give permission to redact (remove) any information that is confidential pursuant to the Attorney General's Public Information Act, Sections: 522.101: Judicial Decisions: 552.102: Employees' personal privacy; 522.117: employee address, telephone nos., Social Security Nos, personal family information; 522.1175: personal information of security officers; 522.130(a); Driver's License , Permit, Title, Registration, Personal ID; 522.137: email addresses when communicating electronically with governmental body.
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Please select one:
YES
NO
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Requestor Signature:
If you need any further assistance, please contact the
Open Records Department at:
Kim Coutee- 281-420-6684
Kristen Mills - 281-420-6673
Public Records Request by Destiny Software, Inc.