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Request crime information - Appendix D (a)

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

After submitting this form, you will need to make a Bacs payment, quoting the form reference number, to:

  • PCC for Avon and Somerset
  • Account number 29530598
  • Sort code 60-80-06

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
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