San Rafael Police Department

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RECORDS REQUEST

Records requests take at least 10 business days to complete after the report has been received from the records department. Please note that it may take time for the report to reach our records department if the investigation is on-going, or if the officer has not yet completed the report.

We do not release police reports to a party or parties if they are listed as a suspect or suspect arrested in the report.

Request Date:	03-27-23
Date/Time of Occurrence:
Type of case:
Case or Incident Number:
Applicant First Name:
Applicant Last Name:
Phone Number:
Email Address:
Select Delivery Method:*

* Pickup not available due to COVID-19 related service modification.

Mailing Address:

Address:
City:
State:
Zip

Party of Interest:
Victim
Driver
Passenger
Property Owner
Parent or Guardian for:

Parent/Guardian for:

Attorney

Attorney for:
Attach Any Authorization Documents/Letters:

(Note: The file type must be pdf. We cannot accept any other file types.)

Insurance Representative

Insurance Representative for:
Attach Any Authorization Documents/Letters:

(Note: The file type must be pdf. We cannot accept any other file types.)

Authorized Individual
Other Party of Interest

Specify name and relationship:

I declare under penalty of perjury that the above information is true and correct. The theft or alteration of an official document is a felony punishable under section 6201 of the government code.

Protecting the Mission City

San Rafael Police Department

Emergency: 911
Non-Emergency: (415) 485-3000

1375 Fifth Avenue
San Rafael, CA 94901