Video Request Form

To request video footage from the Holbrook Police Department, please fill out the form below. Once we have reviewed the form, we will contact you in a timely manner.

"*" indicates required fields

Defendant Name*

First Last

Date*

Reported Incident*

Case Number*

Camera Requested (ie. Booking, Male Cell #2 etc.)*

Start Time*

End Time*

Arresting Officer

Video For*

Prosecution (goes to prosecutor)

Investigation (goes to requesting officer)

Other (Please describe in the text box)

If you chose "Other" as an option for "Video For," please describe what the requested video is for:

FOR EMERGENCIES DIAL 911

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