Incident Report Number: Date of Incident: Approximate Time: Type of Incident: Choose one... Building Fire Automobile Fire Medical Emergency Rescue Service Call Other... Other: Incident Address: Name of Requestor: E-mail: Phone: Government Agency Request? Yes No Government Agency Name: (if Government Agency Request) Notes:

Note: Opening up the government processes to public scrutiny and participation is the only viable and reasonable method of protecting the public's interest. The policy of conducting government business as openly as possible must be tempered by a recognition of the right of the people to privacy, as embodied in Section 6 and 7 of Article I of the Constitution of the State of Hawaii. Please note that HRS Chapter 92F requires a balancing of interests: the public interest in disclosure of the particular record versus the unwarranted invasion of personal privacy interest of the individuals involved in an emergency incident. Consequently, a request for disclosure of a government record must be assessed on a case-by-case basis and information that is deemed to be of significant privacy interest will be redacted or blocked out.