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Lincoln Police Department

APPLICATION FOR RELEASE OF INFORMATION (General Order A87-112, Section 112.8)

Date

Report Number

Name of Suspect / Offender

Location of Occurrence

Date Reported

Type of Report

Vehicle Accident Report

Crime / Indicent Report

Status of Requesting Party

Victim / Parent or Guardian of Victim

Authorized Representative of Victim

Insurance Carrier

Person Involved in Accident

Owner of Damaged Property

Press

Interested Party (specify below)

Signature

Clear

Type Name

Name of Company or Business

Email Address

Address

City

State

Zip Code

Phone Number

Cell Phone Number