Accident Report Request

Accident Report Request

Name/Organization of Requestor(Required)
Name of Involved Person(Required)
MM slash DD slash YYYY

Confidentiality Notice:  By submitting this request, you are certifying that the information is true and correct and that you are authorized to receive the report.  The information transmitted in this email is intended only for the person or entity to whom it is addressed, and contains confidential and/or privileged material that may be subject to protection under law.  If you are not the intended recipient(s), any review, transmission, dissemination, disclosure, copying, or other use of this transmission including taking any action in reliance upon this information, without the express written approval of the East Lampeter Township Police Department is strictly prohibited and may subject you to criminal and/or civil penalties.  If you received this message in error, please contact the sender immediately by replying to this email and delete this message from your computer and destroy all copies of this original message.