Case Charging/Dispositional Status Inquiry Complete the form below to request information about a prior arrest or criminal charge. Name Phone Number Email Address Street Apt/Lot City State Zip Date Of Birth Driver's License Number (Optional) Date of arrest/citation Law Enforcement Agency (ex: Bloomington Police Department, Monroe County Sheriff's Office, Excise, etc.) Alleged Criminal Offense (ex: shoplifting, DUI, trespass, etc.) Purpose for Requesting Charging/Dispositional Information Additional Comment