211 Walnut Street, Neenah, WI, 54956, US
This form is for incident reports only. Accident reports are obtained via the Wisconsin Department of Transportation website crashreports.wi.gov. Page 2 must be completed and signed prior to non-redacted records being released.
Your record(s) will be processed within ten (10) business days from your request unless otherwise notified. Records not picked up within seven (7) days will be DESTROYED. If your request is denied an explanation will be given.
FEES: (Due Upon Receipt)
Requests requiring research will be assessed labor fees if research time equals or exceeds $50.00 in costs at $21.85 per hour.
Emailed Record: No Charge
Copies, 0-25 Pages: No Charge
Copies, 26-50 Pages: $0.25
Digital Media, 4 GB Flash Drive: $2.10
Digital Media, 8 GB Flash Drive: $2.30
Digital Media, 16 GB Flash Drive: $2.60
(Larger Flash Drives Available for Increased Fee)
Party Name to the Accident/Incident
Party Name DOB
Federal Driver Privacy Protection Act Permissible Uses Form-Authroization
Based upon the Federal Driver’s Privacy Protection Act, this request must be completed before information containing personally identifiable information in the Police Report can be released without redaction. Knowledge of what access and uses are permitted under the listed Federal Act is the responsibility of the Requester.
See the following for allowable exemptions for non-redacted records being released.
Authorization - The Driver’s Privacy Protection Act is enforced by the United States Department of Justice, which may seek civil and criminal penalties for improperly obtaining, disclosing, or using personal information from an accident report or other police record, or the information was acquired through the Wisconsin Department of Transportation System and it is determined that these records are used for purposes other than as stated in this Request.
I/We are authorized under the Federal Driver’s Privacy Protection Act to obtain the identified accident/incident report and personal information based upon the following (mark all applicable boxes):
I/We certify that the information and statements on this request are true and correct, comply with the provisions of the Federal Driver’s Privacy Protection Act and understand that the willful, unauthorized disclosure of information obtained from these records for a purpose other than stated on this request, or the sale or other distribution of the information to a person or organization not disclosed in this request may result in civil and criminal penalties imposed under Title 18 U.S.C. Section 2724. I/We will also defend, indemnify, and hold harmless the City of Neenah and its employees or agents from all claims, actions, damages, or losses, arising from my/our representations made in the execution of this form, whether said representations were negligently or intentionally made to said City.