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2. RECORDING REQUEST FORM
4. I hereby request a recorded copy of the below listed incident for law enforcement purposes.
6. Your Name & Title:*
7. Your Agency:*
9. Your e-mail Address:*
10. Your Phone Number:*
12. Date & Time of Incident: (+/- 15 minutes)*
    Date & Time of Incident: (+/- 15 minutes)

    Date & Time of Incident: (+/- 15 minutes)
13. Case #:
15. Location & Description of Incident:*
17. Channel(s) to be Recorded:*

    1. Radio
    2. Telephone
    3. Radio & Telephone
    4. Text-2-911 Transcript
18. Method of delivery:*

    1. CD (Pick-up)
    2. Upload to Evidence.com
    3. Via e-mail
20. Special Instructions:
22. Date Needed By:*
    Date Needed By:
24. ==============================================================================================
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field