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2. First Name*
3. Middle
4. Last Name*
6. Address*
8. City*
9. State*
10. Zip Code*
12. Phone Number*
13. Email*
17. Case Number*

    If you do not have a case number, you should come to the Portland Police Deparment in person, so we can locate the correct report.

19. Record(s) requested

    1. Accident Report
    2. Incident Report

    1. Arrest Report
    2. other

    NOTE: If you select "Other" you must provide detailed descriptions of the record(s) including relevant date(s) and subject matter.

21. Date*
    Date

    Date
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23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

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