Brush Police Department
Request to Release Criminal Justice Records

(Email requests must either have this form attached or similar language/information affixed)


Criminal Justice Records are governed by CRS 24-72-301 et seq.


Party Requesting Information:

Name: ____________________________________________________    Attorney Reg. #: __________________

Address: __________________________________________________     Telephone: ______________________

DL#/ID#: __________________________________________________     Date of Birth: ____________________


Type of record requested:      Police Report (narrative)      Traffic Report             Other

If “other” please describe: ______________________________________________________________________

Case Report #: ____________________   Date of Incident: _______________  Type of Incident: _____________

I understand that CRS 42-72-305.5 prohibits me from using these records for the purpose of soliciting business for pecuniary gain.

Signature: __________________________________________________________________________________________

Charges for records are governed by 24-72-306 and City/BPD Fee Structure

 

(FOR OFFICE USE ONLY)

Total Amount Due: ____________________             Date of Release: __________________

Signature of party picking up records: ___________________________________________________________________

Records released/denied by: __________________________________________________________________________        

Reason Denied: ____________________________________________________________________________________

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