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Request to Investigate

2. Request to Investigate
   York County Department of Public Safety Communications

   York County Department of Public Safety Communications

3. Date of Request:
   Date of Request:

5. Reporting Person:

6. Department / Organization:

8. Home / Cell phone

9. Business Phone:

11. Email:

13. Type of Incident:

    1. Fire
    2. Law Enforcement
    3. Medical

15. Location of Reported Incident:

17. City:

18. Date and Time of Incident:
    Date and Time of Incident:

    Date and Time of Incident:

    Approximate time is fine.

20. Public Safety Communications Personnel Involved:

    (if known)

22. Comments:

24. Date Received:
    Date Received:

25. Received by:

26. Assigned to:

28. Response Due Date:
    Response Due Date:

29. Date Completed:
    Date Completed:

31. Notification made via:

    1. Phone
    2. Email
    3. Other

33. Other

35. Date Notified:
    Date Notified:

37. Signature of personnel completing investigation:

Leave This Blank:


39. Submit

* indicates a required field