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2. Request Date*
   Request Date

   Request Date
4. First Name*
5. Last Name*
7. Address1*
9. Address2
11. City*
12. State*
13. Zip
15. Telephone Number*
17. Incident Date*
    Incident Date

    Incident Date
18. Case Number
19. Officer's Name
21. Case type and names involved*
23. Description of items to be released*
    Name items that you want returned
25. Check here

    1. Has case gone to court
26. If yes, when was the court date?
28. The evidence technician will research your case file and will call you with information regarding your request.
30. Signature
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field