Form Center

2. Northeast Communications Center
   126 S Lebanon Road
   Loveland, Ohio 45140
   Phone: 513-677-7000
4. The Northeast Communications Center is pleased to make available to you all information not exempted from disclosure by the General Assembly of the State of Ohio. To assist us in evaluating your request, please fill out this form completely. We will provide you with all non-exempt requested information as soon as possible, usually within 5 business days of this office.
6. Requester Information
8. Name
10. Title / Rank
12. Agency Name
13. Email
    Please type email we can send records to
15. Agency Phone
16. Home Phone
18. Incident Information
20. Address or Place of Occurrence
22. Briefly describe the incident.
24. Incident Date & Time
    Incident Date & Time Start Date

    Incident Date & Time Start Time

    —

    Incident Date & Time End Date

    Incident Date & Time End Time
26. Information Requested
28. Copies Of

    1. Call for Service Printout
    2. RCIC/LEADS/NCIC (Criminal Justice Employees Only)
30. Recordings Of

    1. Radio
    2. Telephone
32. Radio Recordings
    Please specify the time frame and what to record.
34. Telephone Recordings
    Please specify the time frame and what to record.
36. Reason for Information Request
38. Intended Use
40. Disposition After Use

    1. Destroy
    2. Disclose to Named Person
    3. File
    4. Other
42. Specify Named Person
44. Explain Other
46. Important Understanding
    I understand and agree that my use of the information requested for any purpose other than stated herein, or the falsification of any information on this sheet and/or accompanying copies may be a violation of law, and I specifically agree not to disseminate this information further without prior written approval of the Director of Northeast Communications.
    
    Note: Recordings involving excessive work hours may incur a charge payable prior to the release of the information.
48. Requested By
50. Date & Time
    Date & Time

    Date & Time
Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit

* indicates a required field