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2. First Name*
3. Last Name*
5. Address 1*
7. City*
8. State*
9. Zip*
11. Phone Number*
12. Email Address*
14. Police or Court Record Request
    Police or Court Record Request Form

    For Municipal Court or Police Department records, please use the link above to submit your request.

15. Other Departments*

    1. Building Permits, Licensing & Inspections
    2. Code Enforcement
    3. City Clerk

    1. Finance
    2. Planning & Community Development
    3. Utility Billing
17. Record (s) Description*

    Please provide a specific description of the record(s) you desire to receive. Include record title, date, originating city agency/department, or any other pertinent information.

19. Approximate Date Record(s) Created

    Please provide a date range when the requested record(s) were created. (eg. "1998 to 2002", "01/2023 to 04/2023" etc.)

21. Signature of person making the request
23. Do you agree?*

    By clicking I agree, you agree and acknowledge that
    1) your application will not be "Signed" in the sense of a traditional paper document and
    2) by signing in this alternate manner, you agree that your electronic signature is valid and binding upon you to the same force and effect as a handwritten signature.

    1. I Agree
27. Charges:

    A charge for providing access to public records is authorized by state law and has been established by the city governing body. These charges are set at a level to compensate the city for the actual costs incurred in honoring record requests.

    
    

    Printed pages @ $0.25 per page.

    Hours @ $20.00 per hour

    
    

    Complete fee schedule can be found on the website or at City Hall. If you have questions regarding fees, please contact the City Clerk at (316) 744-2451.

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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

* indicates a required field