REQUEST FOR CCTV ACCESS
DEPARTMENT OF SCIENCE AND TECHNOLOGY
Regional Office No. IX
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Date of Request:
Location of CCTV to access/view:
Reason to access the CCTV:
Date and Time of incident to access/view:
Request a copy of video footage:
Please provide a USB Flash Drive or other storage media (CD, DVD, etc.)
Maybe, if video footage seen is of value.
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This form was created inside of Department of Information and Communications Technology.