Police Department

Records Request Form

Please Fill out the Form Below to Submit a Formal Request of Records from the Burlington Police Department.

Requester Information
Agency/Business making request, if applicable.
First Name of Requester Submitting Form
Last Name of Requester Submitting Form
Phone Number of Requester Submitting Form
Incident Detail
The following pertains to the Incident
:
Please provide your Date of Birth
Other Parties Involved
First Name of Additional Party Involved
Last Name of Additional Party Involved
Please enter Date of Birth for this Party
First Name of Additional Party Involved
Last Name of Additional Party Involved
Please enter Date of Birth for this Party
Please Specify the Information that you are requesting.
NOTE:
Once submitted you will receive an automated email with information on how to add additional details to your Public Records Request. Simply Reply to the automated email with attachments, or additional information.