RECORDS DIVISION UNIT - Chicago Police Department

1 DIGITALLY RECORDED DATA VIEWING/ hold /DUPLICATION/SHARED REQUESTCHICAGO Police DEPARTMENTDATE OF REQUESTDIRECTORTO:FROM: RECORDS DIVISIONUNIT:INSTRUCTIONS: PLEASE PROVIDE THE INFORMATION REQUESTED BELOW. COMPLETE A SEPARATE FORM FOR EACH REQUESTEXTENDED HOLDDUPLICATION/SHARED REQUESTADDITIONAL REMARKS AND INFORMATIONREQUESTER'S NAMEREQUESTER'S SIGNATURERANKSTAR/EMPLOYEE COMMANDER'S /DESIGNATED SUPERVISOR'S SIGNATURE/STAR RECORDS DIVISION USE ONLYADDITIONAL INFORMATIONTHE RECORDS DIVISION WILL FORWARD A DUPLICATE VIDEO TO THE TRAFFIC ADMINISTRATION unit , IF VEHICLE PURSUIT RELATED ORTO THE DEPUTY CHIEF, EDUCATION AND TRAINING DIVISION , IF TRAINING (REV.)

2 10/16)REQUESTREMOVALVEHICLE PURSUITTRAINING RELATEDOTHER, SPECIFY:OUTSIDE VEHICLE NO.(Useful Law Enforcement Purposes Only)EVENT NO. (10 DIGIT)INVOLVED MEMBER'S NAMEFOR DUPLICATION/SHARED REQUESTSEXEMPT-LEVEL unit COMMANDING OFFICER APPROVALIN-CAR VIDEOBODY WORN CAMERAELECTRONICALLY RECORDED INTERVIEWHELICOPTER VIDEOEMPLOYEE MEMBER'S NAMEEMAIL ADDRESSPC OF INCIDENTTIME OF INCIDENTDISTRICT OF INCIDENTLOCATION OF INVOLVEDTYPE OF INCIDENTDIGITAL DATA record NO. VIEWED/PROCESSED/DUPLICATED BYDATE:MAIL DELIVERYDATE SENTVIAREQUESTER PICK-UPDATE PICKED UPBY