Rollinsford Police Department Report Request Form

Rollinsford Police Department

Report Request Form
Please complete the following for to request an accident report, incident report, arrest report or any other record. Fields marked with an * are required. The fee for an accident report is $20.00 and all other reports are $10.00. The fee must be submitted with this request. Once the report is cleared for distribution, a copy will be given to you or mailed. Open reports shall not be distributed until the investigation has been closed.
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
email address
Report number
if known
Incident Date

MonthDayYear
Date
Incident Location
Record Type

Other
Reason for Request

Other
Involvement

Other
How would you like the requested report returned to you?
Signature
Today's Date

MonthDayYear
Should be Empty: