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2. 
3. Firestone Police Department Request for Criminal Justice Records

   This completed form documents your request to inspect criminal justice records in the custody of the Firestone Police Department and will be retained in the record’s file. This form is a public record and may be released. 

   The following information is necessary to process your request. Please provide as much information as possible. Colorado law requires your request contain information specific enough to identify the exact record requested. Please provide an email address to receive the record by means of the Internet. ALL requests must be accompanied by a copy of the requestor’s valid driver’s license or government-issued identification.

5. Person Requesting Record(s):*
7. Mailing Address:*

   (Number and Street)

8. City:*
9. State:*
10. Zip Code:*
12. Phone:*
13. Email:*
17. Case Report #:
18. Type of Incident:
20. Date of Incident:*
    Date of Incident:
21. Location of Incident:*

    Address or Intersection

    
    

23. Person Involved in Report:
24. Date of Birth:
    Date of Birth:
26. Requestor's Involvement in Case:*

    1. Victim
    2. Complainant
    3. Witness
    4. Arrestee
    5. Suspect
    6. Other
28. Explain Other
30. First Name:*
31. Last Name:*
32. Date of Birth:*
    Date of Birth:
34. Upload Photo Identification*

    To process your records request, please upload a copy of your driver’s license or a different form of photo identification. 

38. Check The Information Requested:

    NOTE: A research/retrieval fee will be assessed for every request. $30 hourly, ½ hour minimum required. A quote will be issued and is considered an estimate as it may be subject to change based on the request, redaction required, and review. Full payment of the estimate is required before the request will be processed. Additionally, a refund will be issued if the redaction and review take less time.

    There is a separate form for body-worn cameras, photos, and dash cameras (Request for Criminal Justice Digital Evidence).

    Payment can only be made via exact cash, check or credit card (made out to the Town of Firestone).

    1. Case Report: $5.00 for each searched case report
    2. Clearance Letters: $10.00 per document
    3. Other
42. Signature:*

    By signing this form, I acknowledge that I have read and understand the below Colorado Revised Statute and affirm that the records of official actions and criminal justice records I am requesting shall not be used for the direct solicitation of business for pecuniary gain. 

    1. I have read and agree to the terms and the conditions stated above.
44. Name:*
45. Date:*
    Date:

47. C.R.S. 24-72-305.5 ACCESS TO RECORDS- denial by custodian- use of records to obtain information for solicitation.  RECORDS OF OFFICIAL ACTIONS AND CRIMINAL JUSTICE RECORDS AND THE NAMES, ADDRESSES, TELEPHONE NUMBERS, AND OTHER INFORMATION IN SUCH RECORDS SHALL NOT BE USED BY ANY PERSON FOR THE PURPOSE OF SOLICITING BUSINESS FOR PECUNIARY GAIN.  THE OFFICIAL CUSTODIAN SHALL DENY ANY PERSON ACCESS TO RECORDS OF OFFICIAL ACTIONS AND CRIMINAL JUSTICE RECORDS UNLESS SUCH PERSON SIGNS A STATEMENT WHICH AFFIRMS THAT SUCH RECORDS SHALL NOT BE USED FOR THE DIRECT SOLICITATION OF BUSINESS FOR PECUNIARY GAIN. 

Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit

* indicates a required field