Pursuant to the Kentucky Open Records Act ("The Act"), KRS 61.870 et seq., the undersigned requests to inspect the public records which are described below:

*Information is required

Contact Information

* Your Name:

* Your Email:

* Daytime Phone:
()   - 

* Address:

* City:

* State:     Zip:

Type of Incident:
0-4000 Characters - Total Used 0

Date of Incident:

Time of Incident:

Address of Incident:

Name(s) of Person(s) Involved:

Case Number

Court Case Pending?
YesNo

Information Requested:
Copy of Police ReportPhotographsVideo

Additional Information Requested:
0-4000 Characters - Total Used 0

Preferred Method for Information Return:
MailEmailPick-up at: Villa Hills Police Department

Reason for Request:
0-4000 Characters - Total Used 0

Statement regarding the use of public records. KRS 61.870(4) defines "commercial purpose" as "the direct or indirect use of any part of a public record or records, in any form, for sale, resale, solicitation, rent, or lease of a service, or any use by which the user expects a profit either through commission, salary, or fee." However, "commercial purpose" does not include the publication or related use of the public record by a newspaper or periodical, by a radio or television station in its news or informational program, or by use in the prosecution of defense of litigation by the parties to such an action or their attorney.

This request is (Choose one):
NOT for a commercial purposeFOR a commercial purpose

Statement regarding residency: I further state that I am a resident of Kentucky because I am (please choose one):
An individual residing in the CommonwealthA domestic business entity with a location in the CommonwealthA foreign business entity registered with the Kentucky Secretary of StateAn individual that is employed and works at a location within the CommonwealthAn individual or business entity that owns real property within the CommonwealthAn individual or business entity thta has been authorized to act on behalf of an individual or business entity listed above, orA news-gathering organization as defined in KRS 189.635(8)(b)1a. to e.

Pursuant to KRS 61.874(4), the Office of Attorney General has promulgated by administrative regulation this form. See 40 KAR 1:040.