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Request for Public Records Name Check

  1. This is the public records request name record check form for the Eugene Police Department. Please fill out this form completely to the best of your ability. The more information you provide, the easier it is for us to complete your request in a timely manner.
  2. Please fill out one request form for each different request.
  3. Subject of Request*
  4. Type of Contact *
  5. Version*
  6. Version*
  7. Please provide any additional information about the records you are requesting.
  8. Do you agree?*
    By clicking I agree, you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your electronic signature is valid and binding upon you to the same force and effect as a handwritten signature.
  9. Leave This Blank:

  10. This field is not part of the form submission.