2. Request for Information
   There may be times in which our office cannot process your request due to limitations within the State of Minnesota Data Practices guidelines. In other instances, our office may need to contact you for further information to process your request. Therefore, it is important that we have your contact information on the Request for Information Form in case our office needs to contact you.
4. Requestor's Information
   Completing this form in its entirety helps us to get you the information as quick as possible.
6. First Name
7. Last Name
9. Address 1
11. Address 2
13. City
14. State
15. Zip
17. Phone Number
18. Email Address
20. Classification of Data:*

    1. I am the subject of the data.
    2. I am not the subject of the data.

    If the information you are requesting is about you personally, then you are the "subject of the data".

22. If you are not the subject of the data, a consent for release of information is required.
    Informed Consent for Release of Information (PDF)
24. Type of Data Sought:

    1. Police Reports
    2. Photos on CD ($25 fee)
    3. Photos on Paper ($2 per page)
    4. Video on CD ($35 fee)
26. How would you like your information returned to you?

    1. In Person
    2. Email
    3. Fax
28. Fax Number
    If you would like the information faxed to you, please enter the number here
30. Information Requested
    Please provide details on the information requested.
32. Case Number
    Please enter your case number, if known.
34. Brief summary of the incident
    Please include approximate dates/times of occurrences; or other type of information requested, being as specific as possible.
36. Release of Information
    If you have a release of information form you would like to submit with your request, upload it here.
38. Signature of Submission and Disclaimer:
    I understand that the Coon Rapids Police Department will make final determination as to the release of information as per standards set forth by State of Minnesota Data Practice Guidelines and fee schedules. The Coon Rapids Police Department responds to requests in the order they are received, typically within seven (7) business days of receiving the request.
40. *There is no charge for the first three pages of a report. After that, it is $0.25 per page. If the reports are emailed or faxed, you will receive an invoice with your reports if there is a fee.
42. Minnesota Government Data Practices Act:

    This information is not legally required but used for the sole purpose of facilitating access to the data.  Once the request has been completed, this form will constitute a public record.   The purpose and intended use of this information is to process your request, contact you if additional information is needed and, when requesting private or confidential data on individuals, to determine authority to access the data.

Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit Submit and Print

* indicates a required field