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Request crime information - Appendix D (a)

Insurance companies and their representatives can use this form to apply and pay by card, for information relating to a crime reported by their insured parties (Appendix D (a)).

If you are a member of the public, you will need to apply for access to your personal data.

This form takes about 10 minutes to complete.

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To fill in this form

You will need:

  • insurer details
  • claim number
  • name, address and date of birth of insured party
  • details of the crime, including reference number, date and time reported
  • aggrieved person's name and date of birth
  • credit or debit card details for payment
Other ways to request crime information

If you do not have a payment card, you can download the Appendix D(a) (PDF) and make a Bacs payment.