Request for Public Records

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Date of Request *

Date of Incident *

Time of Incidient *

First Name *

Last Name *

Street Address Line 1 *

Street Address Line 2 *

City *

Zip *

Phone *

Email *

Name of Person Involved *

Description of Person Involved *

Description of Incident *

Specific type of Record (video?) *

Bus Number *

Route Number *

Location of Bus *

Direction of Bus *

Description of Operator *

Description of Event *

Was the incident reported? *

Yes

No

Did a supervisor respond? *

Yes

No

Were there any calls made to KCATA regarding the incident? *

Yes

No

If yes, what date and what phone number was called from? *

I request copies of the records, and therefore, am willing to pay for the copies. Let me know in advance of any search or copying fees. *

My maximum fee to pay limit is *

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