Police Public Records / Reproduction Request

Town of Chino Valley Police Department
Phone: (928) 636-3600
Email: policerecords@chinoaz.net

FEES ARE NON-REFUNDABLE and payable by cash or Visa / Mastercard upon picking up request. All Body worn camera and Picture request payment will be paid prior to the redaction process. Upon notification records are available, they must be picked up within 10 business days. Requested records not picked up will be destroyed.

I, hereby request: *

Paper Copies Electronic Copies

Pictures Body Cam

Departmental Report (DR) Number (example 15c-00000)

Date of Incident*

All names involved, include Date of Births (DOBs)

Address of Concern?

Type of Incident (example Accident, Harassment, Sex Offense, etc.)

Special requests / Additional information (example Description, Body Cam, Pictures, etc)

Request Certification

I certify that the public records will be used for: *

Non-commercial purposes

Commercial purposes (*)

(* See below A.R.S. § 39-121.03(D) for definition of “Commercial purposes”.)

If for commercial purposes, describe the manner in which these records will be used:

A.R.S. § 32-101 – I understand that the information requested may include documents that have been sealed by a “technical registrant” (architect, engineer, etc.). I agree to keep and protect the document from further distribution and not to allow further reproduction of the document.

Click below to read:

A.R.S. § 32-101

I declare that I have read A.R.S. § 39-121.01 [Link to Statute below] and/or A.R.S. § 39-121.03 [Link to Statute below] and understand the contents therein.

Click below to read:

A.R.S. § 39-121.01

Click below to read:

A.R.S. § 39-121.03

I further declare under penalty of perjury that the foregoing is correct and true.*

Requestor Information

Date of Request*

First Name:*

Last Name:*

Driver's License Number

State:

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Mailing Address:*

Physical Address:*

City:*

State:*

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Zip:*

Phone Number:*

Email Address:*

Log #: