The accompanying records and recordings and explanatory material are from the (name of agency) public safety answering point communications facility. This form authenticates (number) pages. These documents and tapes pertain to: case number ___________, department report number ____________, call receipt date and time ___________, caller name _____________, call origination location address ____________, originating telephone number _____________, dispatch time ___________, arrival time _______________.
Signed:__________________ custodian of records.
A.R.S. § 13-3989.02