Walworth County Sheriff's Office
Request for Photographic Prints/Digital Media
Date of request______Needed by ______
Requested by ______Request received by______
Name Employee
______
Business / Organization
______
Address
______
City, State, Zip
______
Telephone Nr
Sheriff's Case Number:______Date(s) Photo's Taken: ______
Property Tag Number(s) ______SPD Case number:______
(if applicable)
35mm Prints8" X 10" $10.00 each
5" X 7" $ 5.00 each
4" X 6" $ 3.00 each
Glossy
Matte
______
Videotape $20.00
Micro-cassette $10.00
Other instructions / Digital Media
8" X 11" page (360 dpi inkjet paper) $8.50
8" X 11" page (glossy photo paper) $10.00
Compact Disc CD/DVD $10.00
(includes audio, video recordings)
E-Mail $20.00
E-mail address
Other instructions
______
Do Not Write Below This Line
Date Request Received: ______
Date Request Received by Property Officer: ______
Date Sent to Printer: ______
Date Delivered to Requestor/Method ______
Total Charge: ______
Paid/Date/How/By Whom: ______
(or invoiced by whom/date) Return this form to:
Walworth County Sheriff's Office
Central Records
P.O. Box 1004
Elkhorn, WI 53121
Voice 262-741-4470
Fax 262-741-4492
I hereby acknowledge receipt of the requested materials.
______(legible signature)
______(date)