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2. The term “public record” shall have the meaning given to such term in the Pennsylvania Statute section 708 of Act 3 of 2008. Those records maintained by the Whitpain Township Police Department that are exempted from release or disclosure, and release of those records will be denied, are as follows: 

   1.  Investigative Reports  
   2.  Criminal History Information 
   3.  Juvenile Records (unless the juvenile delinquent is transferred to adult court for prosecution)
4. Name of Requestor*
5. Street Address
7. City
8. State
9. Zip Code
11. Phone*
12. Email
13. Date of Request
    Date of Request
15. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
17. Electronic Signature
19. Review or Duplication

    1. Review
    2. Duplication

    1. Both

    I Request review or duplication (check applicable boxes) of the following records.
21. Records Requested*
    Important: You must identify or describe the records with sufficient specificity to enable the Township to Determine which records are being requested. Use additional sheets if necessary.
23. For Official Use Only:
    The fields below are for official use only. Please do not complete these fields.
25. Request Number:
26. Date
    Date
28. Approved
29. Date
    Date
31. Denied
32. Date
    Date
35. Request Reviewed By
37. Comments
39. Total Number of Reports
40. Total Number of Photographs
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field