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Farmington Police Department DVD Request

  1. Request # (to be filled out by FPD personnel)________________________
  2. Contact Information for Person Making Request
  3. Request Information
  4. THIS SECTION TO BE COMPLETED BY THE IT DIVISION
  5. Date received by IT Division __________________
  6. Video available: ____Yes ____No
  7. If unavailable, reason:
  8. Date completed: _____________
  9. Completed by: __________________
  10. Requester notified that DVD is ready to be picked up.
  11. Date: ____________
  12. Name: ____________________________________________________________
  13. ADM 006 004
  14. Leave This Blank:

  15. This field is not part of the form submission.