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Non-Emergency Crime Reporting Form
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This form has been modified since it was saved. Please review all fields before submitting.
CONTACT INFORMATION
First Name
*
Last Name
*
Address
*
City
*
State
*
ZIP Code
*
Phone
Email
Date of Birth
*
REPORT INFORMATION
Address Where Crime Occurred
*
City
State
ZIP Code
Date of Crime - Crime occurred from what date/time to what date/time?
Date
*
Date Start Date
—
Date End Date
Start Time
Start Time Start Time
—
Start Time End Time
Witness Information
First Name
Last Name
Address
City
State
ZIP Code
Phone
Email
Defining Characteristics
(Example: glasses, beard, tattoos)
Victim Vehicle
Year
Make
Model
Color
License Plate Number
State
Suspect Vehicle
Year
Make
Model
Color
License Plate Number
State
Unusual Characteristics
Lost, Stolen, or Damaged Property
Please List Item(s): Quantity, Article Type / Brand, Color, Model Number, Serial Number, and Estimated Value
Please provide information about your lost, damaged, or stolen property.
Narrative / Witness Statement
Please give a narrative / witness statement.
*
Add a photo or document to this report.
Item 1
Item 2
Item 3
AFFIRMATION
I affirm that this information is true and correct.
Please enter your signature name.
*
(Please enter your name as you would sign your signature. Remember it is a misdemeanor to make a false report of a crime.)
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Email address
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