La Plata County Sheriff's Office

Application for the Release of Criminal Justice Records

I, , request the release of :
Records of Official Action (Records Check)
Other Criminal Justice Records (Deputy Reports Criminal or Traffic)
Date of Request

Time of Request

The following Information is needed to identify the correct record

Incident Number: S-
Case Report #
Date of Incident
Time of Incident
Location of Incident
Person involved in Report
DOB
Address
City	*
State
Zip
Requestor's Address
City	*
State
Zip
Email
Phone

Additional Information:

Note: According to Colorado Revised Statute 24-72-305.5, records of official action , criminal justice records, or the names, addresses, telephone numbers, and other information in such records shall not be used by any person for the purpose of soliciting business for pecuniary gain. The Official Records Custodian shall deny any person access to records of official actions and criminal justice records unless such person signs a statement which affirms that such records shall not be used for the direct solicitation of business for pecuniary gain.

Signature:

Date:

Revised 2/04/16

Security Measure