Form Center

Record Request

Type of Public Record Request
Please tell us what type of document(s) you are requesting (Check all that apply)*
1. Motor Vehicle Crash Report
2. Case Investigation Report
3. Call for Service Report
4. Other - Explain in Narrative
Delivery Method*
1. In Person - $10 per request
2. U.S. Mail - $10 per request
Your request will be processed once it is received. Please note that records will not be released until payment has been made in full. Accepted payment methods are cash or check only. Checks should be made payable to The West Burlington Police Department.
Additional Fees:
- Video Footage - $25 each
- Extended Processing Time - If ANY record request takes longer than 1 hour to process, the West Burlington Police Department will charge an hourly rate for the time required to fulfill the request.
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Information for Locating the Record
To help us serve you better, please provide as much information as possible so we can locate the record you are requesting.
Case Number / Call for Service Number (or both)
Name of the Involved People (separated by commas)*
Location of Occurrence
Date and Time of Occurrence (approximate)*
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Your Information
To assist you with this request, we require some contact information to provide the record.
Purpose of Request*
For documentation and compliance purposes, please specify the intended use of the requested record.
Name of Requestor*
First, Middle, Last Name
Phone Number*
Business
If you are requesting on the behalf of a Business, please list Buiness Name
Email Address*
Address*
City*
State*
Zip Code*
Is your physial address the same as you mailing address?*
1. Yes
2. No
Mailing Address*
Street Address/PO Box, City, State, Zip
If necessary, include any additional information or instructions that will assist in fulfilling this request

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