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POLICE REPORT REQUEST FORM
201 West Mission Street, San Jose, CA. 95110
Accident Reports Fees ……… Please make your check payable to “City of San Jose”
Crime Report Fees …………… (Fees will be calculated based on the number of pages in the report.)
Include a Copy of your Photo I.D. AND your Check made out to:
“Visit the link below for instructions describing how to make out your check.”
Fees Change Annually – For an updated Fee Schedule visit: http://www.sjpd.org/Records/Fees.html
If your were cited or arrested in relation to the requested crime report, contact the District Attorney’s office for the
requested documents at (408) 299-7400
Please complete all four sections below and sign: ONLY one report per request form. Please provide as much
information as possible. This form may be delivered in person or mailed to the police department.
Please include a self-addressed stamped envelope to ensure prompt delivery.
(Type out information or print out and fill in by hand.)

1. Your Name: ______