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2. Date*
3. Requester's Name*
5. Mailing Address*
7. City*
8. State*
9. Zip*
11. Phone Number*
13. I would like to inspect and copy the following records:*
    List records with reasonable particularity and include date, time, location, persons involved and nature of incident. (Video footage requests must include DVD Request Form along with this form.)
15. Fee Disclosure
    I agree to pay the applicable fees for copying and transmitting the records. If the charges will exceed (type amount in box to the right) please call me to discuss. I understand that I may be asked to pay the fees in advance. Please provide a receipt indicating the charges for each document.
16. If fees exceed the below amount, please call me to discuss
18. E-Signature of Requester *
20. Per NMSA 1978 14-2-8, upon written request custodian shall permit inspection as soon as possible or within three business days, but no later than 15 days. If inspection is not permitted within 3 days, the custodian shall explain in writing when the records will be available. If the request can’t be allowed within 15 days, a written notice will be mailed advising of the denial or extra time needed if the request was determined to be excessively burdensome or broad.
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22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit Submit and Print

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