GLENWOOD SPRINGS POLICE DEPARTMENT

Today's Date

FIRST NAME

LAST NAME

DATE OF BIRTH

PHONE NUMBER

STREET ADDRESS

EMAIL ADDRES

CITY

STATE

ZIP CODE

DATE OF INCIDENT

Case Number (2026-XXXXX) *If known:

Please include any additional information *:

Terms of Agreement *:

According to Colorado Revised Statute 24-72-305.5: Records of official action, criminal justice records, or the names, address, 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 action 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.

I understand and agree to the terms as written.

GLENWOOD SPRINGS POLICE DEPARTMENT - REPORT REQUEST FORM