E-Gov Services City of Piqua

WARNING! Please do not use this form to report issues of an emergency nature or for conditions requiring an immediate response. If your issue is an emergency, please use the telephone and dial 911.

Records Request for Piqua Police Dept.

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Purpose. This form is used to request copies of records from the Police Dept. Please fill out the following information so that we can email or contact you when the requested documents are ready. If you wish to remain anonymous keep track of your TRACKING NUMBER so that you can log back in to retrieve your requested record.

* Information is required.

Contact Information

First Name:
Last Name:
Business Name:
Email:
Daytime Phone:	() –
Fax:	() –
Address:
City:
State:
ZIP:

Location of incident/accident:

* Address	- Or Other Not Listed - Invalid Address The address you entered does not match any in the system. You can select a valid address from the list, or if you are certain the address you entered is correct click the "Use the address I entered" button, to continue. The address you entered
Unit:
	Provide case number, address, names involved or any additional information on record/report in the box below.

* Check how we should fill your request. Accident Reports are $4.00

Fax

Will Pick Up

Attach a Picture or File (max size: 30MB):

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Check here to have email confirmation of this submission.

* Information is required.

Notes:

If you send us a message, you will receive a Tracking Number allowing you to follow-up with your request, at your convenience.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.