THE KENYA POLICE
ABSTRACT FORM POLICE RECORDS
APPLICATION
NAME………………………………………………………………………………………………………………………………………………….
OF POSTAL ADDRESS……………………………………………………………………………………………………………………………
HEREBY APPLY FOR POLICE ABSTRACT, WHICH WAS REPORTED AT…………………………………………………..
POLICE STATION ON………………………………………INVOLVING…………………………………………………………………
……………………………………………………………………………..DAMAGES ETC………………………………………………………
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DATE……………………………………………………………..SERIAL NUMBER…………………………………………………………..
ABSTRACT FROM POLICE RECORDS……………………………………………………………………………………………………..
NAME:…………………………………………………………………………………………………………………………………………………
ADDRESS…………………………………………………………………………………………………………………………………………..
OFFICIAL RECEIPT:………………………………………………………………………………………………………………………………
REPORT ALLEGED TO HAVE BEEN RECEIVED ON……………………………………………………………………………….
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SIGNATURE………………………………………………………………………………………………………………………………………….
OFFICER INCHARGE POLICE STATION
RECEIPT FOR CASH KSH……………………………………………………………………………….