Online Police Reporting Form

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Today's Date: MM/DD/YY

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Today's Date: MM/DD/YY

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You are the:

You are the:

Complainant

Witness

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First Name:

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First Name:

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Last Name:

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Last Name:

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Street Address:

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Street Address:

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City/Town:

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City/Town:

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State:

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State:(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

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Zip Code:

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Zip Code:

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Date of Birth: MM/DD/YY

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Date of Birth: MM/DD/YY

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Driver's License Number:

Driver's License Number:

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Home Telephone #:

Home Telephone #:ext.

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Cell Phone #:

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Cell Phone #:ext.

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Email Address:

Email Address:

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Vehicle Registration / License Plate #:

Vehicle Registration / License Plate #:

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Vehicle Registration State:

Vehicle Registration State:(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

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File Upload: If you would like to submit any photographs or supporting documents please do so here

File Upload: If you would like to submit any photographs or supporting documents please do so here Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

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Select the nature of the complaint:

Select the nature of the complaint:

Abandoned Vehicle

Bullying Activity

Complaint (General Nuisance)

Fraudulent Credit Card Use

Harassing Phone Calls, Text Messages, Emails, etc.

Identity Theft

Lost Property

Supplemental Info for Previously Reported Event

Suspicious Activity, Person or Vehicle

Theft (Value Under $1,500)

Theft from a Vehicle

Theft of Mail or Package(s)

Theft of Motor Vehicle Parts

Vandalism

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Please describe, in as much detail as possible, your complaint:

 *

Please describe, in as much detail as possible, your complaint:

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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