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2. Name of Requester*
3. Date Incident Occurred:
   Date Incident Occurred:

   Date Incident Occurred:
4. Or Enter Date Range
6. Address of Requester*
   Address, City, State, Zip
8. Requester Phone Number*
9. Requester Email Address and/or Fax #
11. Type of Report(s) Requested:

    1. Offense
    2. Arrest
    3. Accident
    4. Other
12. If Selected Other, List Report Here
16. Address / Location of Offense:*
    If address is unknown or NA, please provide best description.
18. Name of Parties Involved:*
20. Additional Information That May Be Helpful In Identifying Report:
22. Select How You Wish to Receive Records:*

    1. Mail Report to Me
    2. Email Report to Me

    1. Fax Report to Me
    2. Call Me and I Will Pick It Up
24. *According To The Open Records Law, This Office Has 10 Business Days To Complete This Request.
26. 1043 Glen Rose Highway Stephenville, TX 76401 | Phone: 254-965-3338 Fax: 254-965-3598
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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

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