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Cedar City Police Department Records Request Form (Police Records Only)

  1. Requester Information:
  2. Status:
  3. Record Request Forms are Public Documents
  4. FOR OFFICE USE ONLY:
    Date Received: ____________________________
    Time Received: ____________________________ AM or PM


    CLASSIFICATION OF RECORD REQUESTED:
    ( ) Public
    ( ) Private
    ( ) Protected
    ( ) Controlled


    CITY RESPONSE TO RECORD REQUEST:
    ( ) Released on: __________________
    ( ) Denied (See Attached) __________________
    ( ) Request for Extraordinary Circumstances (See Attached).


    FEE CHARGED:__________________

    SIGNATURE OF RECORD PROVIDER ____________________________________

  5. Leave This Blank:

  6. This field is not part of the form submission.