Public Records Request Form
In accordance with State Statute / Code _____________, I am requesting
access to ____copy / copies of the following records:
1. Officer _____________'s training records that pertain to his / her
instruction / certification and continuing education of traffic speed
enforcement and to the use of the speed detection device that was used
to ascertain the speed of the vehicle described in citation
2. Officer _____________________'s daily log for the day of
3. Officer _____________________'s radar log for the day of
4. The name, model and serial number of the speed measuring device used
to ascertain the speed of the vehicle described in citation #
_____________ and the serial numbers of the tuning forks used to test
the speed measuring device.
5. Copies of maintenance and / or certification records, for the last
twelve months, of the speed measuring device that was used to ascertain
the speed of the vehicle described in citation # _______________.
6. A copy of the FCC (Federal Communications Commission) license that
authorized the issuing police agency and operator of the speed measuring
device to lawfully operate the device on a specific frequency and / or
range of frequencies.
7. A copy of both sides of the officer's copy of citation #
8. Other record(s) needed:
The records that I am requesting DO / DO NOT need to be certified or
their authenticity verified. If there is an additional charge for this,
I understand that I must pay for that charge.
I am requesting that the requested records be mailed to me at the
I will pick up the records upon notification that they are available.
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