Affiliated Agency Research Request

Affiliated Agency Research Request

The following form is intended for use by agencies affiliated with the ECC (including regional field responder agencies, social services, and Commonwealth’s Attorneys). If you are looking instead for the FOIA request form, you may access it here.

Date of Request *

Requester’s Name *

First

Last

Requester’s Agency *

Agency’s Address *

Address Line 1

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Requester’s Preferred Contact *PhoneEmailFax

Requester's Email *

Requester's Contact Number *

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Incident Information

Date and approximate time of incident *

Location/Address of Incident *

Address Line 1

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Incident/Report Number (if known)

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Records Requested

CAD Records *

• Yes
• No

Phone Calls *

• Yes – All phone calls related to the incident
• Yes – Only 911
• Yes – Other (specify)
• No

Other

Radio Traffic *

• Albemarle County PD
• Charlottesville PD
• UVA PD
• Fire/EMS
• Other (specify)
• None

Other

Incident-specific or All Radio Traffic *

• Related traffic only
• All radio traffic

Real Time or Trimmed Radio Traffic *

• Traffic in real time
• Traffic with dead air trimmed

Cut-off Time for Radio Traffic

Time of day or incident milestone (e.g. custody, last unit clear, unit gives disposition, etc.)

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