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2. You may submit this form online or print, fill out, and return this Records Request Form (PDF) at Email Lauren Roberts or at the Marion Police Department, 550 Mill Street, Marion, MA 02738.

4. Date of Request
   Date of Request
6. Name of Person Making Request
8. Date of Birth
   Date of Birth
10. Street
11. City/Town
13. State
14. Zip Code
16. Phone Number
17. Email Address
19. Fax Number
21. Type of Report Requested

    1. MV Accident
    2. Incident
    3. Domestic Abuse
    4. Arrest
    5. Other (Please explain in next section)
23. Notes
24. Name of Person Involved
26. Date of Incident
    Date of Incident
27. Incident Time
    Incident Time
29. Location of Incident
31. Please Indicate How You Would Like to Receive This Report

    1. Email
    2. Fax
    3. Mail
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field