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Criminal Justice Records Inspection Request

  1. Waiver to Use Criminal Justice Records

    In accordance with Colorado Revised Statutes 24-72-305.5, the undersigned applicant affirms that the information provided by the Kersey Police Department will not be used for monetary gain.

  2. Applicant Information

  3. (if applicable)

  4. Requested Information

  5. Research Information

    (To be completed by Researcher / Custodian of Records)

  6. The following information was released to the requesting applicant on

  7. and

  8. pages were released at a fee of $5 administrative costs and $0.25 per page.

  9. The cost for copies of reports may be waived for victim's pursuant to 24-4.1-303(10)(a)(V).

  10. Leave This Blank: