PRA Request Video form

�		Records Bureau Beverly Hills Police Department 464 N. Rexford Drive Beverly Hills, CA 90210 Office: (310) 285-2101
�	CITY OF BEVERLY HILLS � REQUEST FOR PUBLIC RECORDS VIDEOS	�
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In accordance with the California Public Records Act ("Act"), Government Code 6250 et. seq., the City of Beverly Hills provides access to public records, except those exempt from disclosure by law. �Pursuant to the Act, the City has ten (10) days from receipt of the request to determine whether the request, in whole or in part, seeks copies of disclosable public records in the City's possession and to notify the requestor of that determination. �In unusual circumstances, the 10-day time limit may be extended by up to 14 days by written notice to the requestor, setting forth the records will be made available as promptly as is reasonably practicable.�Fees to cover the direct costs of duplication will be charged in accordance with the City's Schedule of Fees.

Be advised: The footage (if available) will be provided on a DVD disc Windows

only compatible.

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Requestor Information:

Name:

Company (if applicable):

Address:

City:	Zip:
Telephone:	FAX:

Email:

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Record or Document Requested:
Please be as specific and detailed as possible to enable City staff to identify and locate the documents requested. �If known, please indicate in which department(s) the records reside. �Also, please provide case number, location/address of the incident, date range or time period, and other information if known.

Location/Address of the Incident:

City:	Zip:
Case Number:	Type of Incident:
Date of Incident:	Time Period: �to� AM PM

Other Details:

Please upload a color picture of your ID:�

I agree to pay for all applicable fees and charges for copies of records I have requested.

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Date (MM/DD/YYYY)	�Signature of Requestor

Prior to submission, please save a copy of the request.�

Printing to PDF allows a copy to be saved. Once you have obtained a copy, please click the SUBMIT button at the bottom of the application and it will automatically transmit the request via email.�

A confirmation page will appear after successful submission. If not, please email a copy of the application to Police-Discovery@beverlyhills.org�to secure submission.

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