TPD Request For Criminal Justice Information

First Name

Last Name

Home Address

Address Line

Address Line 2

City

State

Zip

Contact Method

To Be Faxed To Be Mailed To Be E-Mailed

DOB

Email Address

Primary Phone

Work Phone

Fax Phone

For Each Incident Report, Photo, Dispatch Chronology, 911 Audio/Radio or Address Search Request the Research & Redaction Time Is Billed in Accordance with City of Thornton Administrative Directive 3-6(4.7a). See Bottom of This Form. The Research Fee For Potential CCTV Footage Is A Non-refundable $50.00. For Any Cases Stored Offsite, an Additional Retrieval Charge of $35.00 Will Be Charged.

Report Requests

Clearance Letter (Thornton Police Records Background Check)

Letter 1

First Name

Middle

Last Name

DOB 1

Letter 2

First Name

Middle

Last Name

DOB 2

Request for Each Dispatch Chronology or Recording

Each Dispatch CD: $50 deposit + $10 material fee = $60.00 each

Type of Request:

911 (Audio Cd) (180 Day Retention from Incident Date)

Yes No

Radio Traffic (Audio) (180 Day Retention from Incident Date)

Yes No

Dispatch Chronology - $1.00 per page (Events Prior to 03/02/2009 May Be Obtained from Adams County Communications Center (ADCOMM)

Yes No

NOTE: Not all areas of the department are under video/audio surveillance. There is no guarantee that an event has been recorded

For Each Event - Dispatch CD $50 Non-Refundable Deposit plus $10 Material Fee = $60.00

Event Number

Case Number

Date and Time of Event

Type of Event

Event Location

Example: 9500 Civic Center Dr, Thornton, CO 80229

Primary Officer

CCTV Surveillance Requests Only

CCTV Surveillance (180 Day Internal / 60 Day External Recording Retention) - $50.00 Non-refundable

Yes No

Camera Location

Lobby Front Parking Lot

Involved Party / Vehicle Description Provide a Detailed Description so We Can Locate the Appropriate Parties and the Vehicles Involved in the Video

Purpose Of Video Request

Child Exchange Other

Purpose Of Video Request Describe the Incident with Specific Details Regarding What You Are Trying to Capture in the Video. Include Precise Location of the Area You Want a Video of (I.E. Sidewalk, Parking Lot, Front Door, or Lobby Seating)

PURSUANT TO C.R.S. 24-72-305.5. I UNDERSTAND THAT COLORADO LAW PROHIBITS ME FROM USING RECORDS OF OFFICIAL ACTIONS AND CRIMINAL JUSTICE RECORDS AND THE INFORMATION IN SUCH RECORDS FOR THE PURPOSE OF SOLICITING BUSINESS FOR PECUNIARY GAIN.

I ALSO UNDERSTAND ANY BOOKING PHOTOGRAPHS OBTAINED WITH THE REQUEST WILL NOT BE PLACED IN A PUBLICATION OR POSTED TO A WEB SITE THAT REQUIRES THE PAYMENT OF A FEE OR OTHER EXCHANGE FOR PECUNIARY GAIN IN ORDER TO REMOVE OR DELETE THE BOOKING PHOTOGRAPH FROM THE PUBLICATION OR WEB SITE.

I HEREBY SWEAR AND AFFIRM THAT THE RECORDS I OBTAINED FROM THE THORNTON POLICE DEPARTMENT AS A RESULT OF THIS OPEN RECORDS REQUEST SHALL NOT BE USED FOR THE DIRECT SOLICITATION OF BUSINESS FOR PECUNIARY GAIN

I Have Read and Understand the above Pecuniary Gain Statement

Yes No

Administrative Directive 3-6

4.7 a) Any records that can be produced in an hour or less shall not include a charge. Research and retrieval time beyond one hour shall be charged a rate of $33.00 per hour in accordance with CORA. In addition shall be charged the actual costs for printed copies or hardware supplied by the City such as USB drives.

4.7 d) For a Records request that requires a time/cost estimate, any records request that will take more than five hours requires a 20 percent deposit prior to any additional research and retrieval. Work on any records request that will take more than five hours shall not commence until a deposit is received.

TPD Request For Criminal Justice Information

Type of Request

Type of Report

Type of Request: