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Citizen Crime Report Form

  1. If you need extra space use next two blocks...
  2. Did Anyone See This Happen?*
  3. Do You Know Who Did This? Any Suspects?*
  4. If you Don't Know Who Did This, Can You Describe Them?*
  5. Did Someone Damage or Take Something From Your Vehicle?*
  6. Describe Your Vehicle
  7. I swear and affirm that the information I have put forth is true and correct. I understand that filing a police report that contains false accusations is a crime and that I may be prosecuted for giving information I know to be untruthful. I understand by submitting this form electronically or otherwise that I am filing an official police report subject to the prosecution guidelines described above.
  8. Electronic Signature Agreement*
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  9. This report has been reviewed by _________________________ on ____________________. I have identified the offense herein
  10. as the offense or incident of _____________________________________________.
  11. Reviewing Officer's Signature: ______________________________________
  12. Leave This Blank:

  13. This field is not part of the form submission.