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2. Requested by:*
3. Email address*
5. Address1*
7. Address2
9. City*
10. State*
11. Zip*
13. Phone number*
14. Alternate phone number
18. If you selected other type of report, please specify:
20. Type of report*

    1. Crime
    2. Arrest
    3. Crash
    4. Call for service
    5. Local background check (name and date of birth must be listed below)

    1. Photos
    2. Body worn camera footage
    3. Dash camera footage
    4. Other (please specify)
22. Incident date and time
23. Location of incident
25. Name and date of birth of person(s) involved - REQUIRED FOR LOCAL BACKGROUND CHECKS
27. Case number or call for service number:
31. Requesting your own record?

    If you are requesting your own record, you are seeking an unredacted record with your personal private information. In that case, do you waive your right to have such personal information redacted? (Ex. drivers license number, account number, etc.)

    1. Yes, I waive my right to privacy.
33. Please sign by typing your name below:

    By signing your name here, you are waiving your right to privacy as stated above.

37. Acknowledgement*

    C.R.S. 24-72-305.5 provides that the records custodian shall deny any person access to criminal justice records unless a statement is signed which affirms that such records shall not be used for the direct solicitation of business for pecuniary gain. 

    1. BY SIGNING BELOW, I AFFIRM THAT I SHALL NOT USE THE REQUESTED INFORMATION FOR SOLICITATION OF BUSINESS FOR MONETARY/PECUNIARY GAIN AND ACKNOWLEDGE THAT SUCH IS A VIOLATION PUNISHABLE AS A CLASS 3 MISDEMEANOR UNDER C.R.S. 24-72-309.
39. Please sign by typing your name below:*
41. Thank you!
    Please note, your request will be processed in the order it was received. You will be notified when your report request has been completed. If you have any questions, please contact us at 303-655-2300 or email recordsrequest@brightonco.gov.
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43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field