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2. Jail Records Request Form

   To receive a copy of any report or record from the Lincoln County Jail you must complete this form and pay the required fees.  Fees are determined in accordance with ORS 192.324(4) and outlined in the Lincoln County Fee Schedule. Staff will review and estimate the amount of time necessary to fulfill your request. An initial $15.00 search fee is required. If the standard research and/or processing time is exceeded, additional fees will be applied. Request Forms may be faxed, mailed, delivered, or emailed to the Lincoln County Jail.

4. Requestor's Information:
6. First Name*
7. Last Name*
9. Phone Number*
10. Email*
12. Mailing Address*
14. Is this request related to a lawsuit or a tort claim involving Lincoln County?*

    1. Yes
    2. No
16. I am requesting the following records(s):*

    1. Booking Photo
    2. Time Served Records
    3. Face Sheet
    4. Jail Incident Report
    5. Other
18. Adult in Custody's (AIC) Full Name:*
19. AIC's DOB:
21. Date of Arrest:
22. Date of Release:
24. SID#
25. Relationship to Inmate: *
27. Please describe the public record(s) you are requesting (be specific):
29. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your form will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
31. Electronic Signature*

33. There are numerous exceptions to the public records laws that allow a public body to refuse to disclose public records (see ORS 192.345, 192.355). Public bodies are not required to create public records where none exist.

37. FOR OFFICE USE ONLY.

    Do not complete the information below. This is for LCSO use only.

39. Date Received:
40. Staff Initials:
42. Fees Paid:
43. Date Paid:
45. Reponse:

    1. Released Full Records
    2. No Records Found
    3. Released Redacted Records
    4. Other Records Provided
    5. Photos/Video Provided
    6. Request Denied/Not Releasable
47. Delivery Method

    1. Mailed/Faxed/Emails
    2. Pick Up
48. If Picked Up, please list the date
50. Processed by:
Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit