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2. Waukee Police Department Application for Public Record

   Please complete with as much information as possible. This request will be processed within 10 business days. The examination and photocopying fees apply according to the City of Waukee's Open Records Policy.

4. Waukee Case Number:*
5. Type of Incident:*
7. Location of Incident:*
8. Date & Time of Incident:*
   Date & Time of Incident:

   Date & Time of Incident:
10. Person(s) Involved:*
12. Any other clarifying facts or information, i.e. arrest, general description of loss or event:*
14. Name of Requesting Party*
15. Phone Number:*
16. Fax:
18. Mailing Address:*
20. Email Address:*
21. Date of Request:*
    Date of Request:
22. Preferred method of receiving request:*
    -- Select One --EmailMailFaxPick-Up
24. This request for public record will be processed within 10 business days. The completed request can be mailed, emailed, faxed or picked up at the Waukee Public Safety Building.
    The address is: 1300 SE L.A. Grant Parkway, Waukee, IA 50263
26. OFFICE USE ONLY
28. Processed by:
29. Date Completed:
30. Delivery Method

    1. Mailed
    2. Picked-Up
    3. Emailed
    4. Faxed
32. Approved by:
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field