All of the following information is required.

Type of crime: Harassing Phone Calls Lost Property Petty Theft (under $400) Vandalism (not graffiti)  

Between what dates and times did the crime occur? ( If you know the exact date and time, enter the same information in the 'Earliest' and Latest' boxes.)  

Earliest Occurrence Date:       Earliest Time:    AM PM

Latest Occurrence Date:          Latest  Time:       AM PM

Location of Occurrence:   

Nearest Cross Street:   

Enter a brief summary of what occurred:

Section 2  -  Property Descriptions

If property was involved, enter as much of the following information as possible for each item.

Item 1:    

Item 2:   

Item 3:   

Item 4:   

Item 5:   

Item 6:   

If you have more items to enter, list them  in the free-form box below.

Additional Items:

Section 3  -  Your Information (required)

As the Reporting Party, you must supply all the following information.

Your Name:    Last    First     Initial

Your Home Address:   

Your City:        State:        Zip:   

Your Home Phone Number:            

Your Business Address:   

Your Business Phone Number:   

Your Drivers License Number:         

Your Date of Birth:         Your Gender:    Male Female

Your Age:         Your Ethnicity:    Unknown White Black Chinese Filipino Hispanic American Indian Japanese Pacific Islander Other Other Asian Cambodian Guamanian Korean Laotian Hawaiian Vietnamese Asian Indian

Your E-Mail Address:   

Section 4  -  Victim's Information (if different from above)

If the victim is a minor for whom you are the parent or guardian, supply the following information. 

Victim's Name:    Last    First     Initial 

Victim's Home Address:   

Victim's City:        State:        Zip:   

Victim's Home Phone Number:       

Victim's Business Address:   

Victim's Business Phone Number:   

Victim's Drivers License Number:         

Victim's Date of Birth:         Victim's Gender:    Male Female

Victim's Age:        Victim's Ethnicity:    Unknown White Black Chinese Filipino Hispanic American Indian Japanese Pacific Islander Other Other Asian Cambodian Guamanian Korean Laotian Hawaiian Vietnamese Asian Indian

Section 5  -  Vehicle Information

If a vehicle was involved complete all of the following.

Vehicle License Number:        State:   

Vehicle Make:        Vehicle Model:   

Vehicle Year:        Vehicle Color:   

Before clicking the Submit button please review all the information you entered to ensure accuracy and completeness. Incomplete reports will not be accepted. (Clicking the Reset button will clear all of the fields on this form.)

NOTE:  The Submit process will take several seconds. Do not click any other browser buttons or you will lose your report. You will see an acknowledgement screen when your report is successfully submitted.