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Incident
Vehicles Involved
Property
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Requestor's IP Address : 3.128.199.1623.128.199.162
Select Report Type
Please select the report type:
Original or Supplemental.
Select
Report Type
Definition
Original
This is the first report you have filed for this incident.
Supplemental
You are adding information to a
previous report
which was
submitted online
.
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Original Online Report Number:
Select Incident Type(s)
Select
Incident Type
Definition
Examples
Bias
Discrimination
Harassment
Select Reporting Person Type
Please select a proper person type according to the definition below.
Select
Person Type
Definition
Individual
If you are reporting this for yourself.
Business
If you are responsible for reporting this for your employer or your own business.
Enter Reporting Person Information
Please enter your information as completely as possible. You may be contacted regarding this incident. An email address is required if you would like to be notified when this report is received and approved.
Person Type:
(BOD) BRASS ON DUTY
BYSTANDER
COMPLAINANT
OFFICER, BACKUP
OFFICER, COMM
OFFICER, PRIMARY
PARKING CUSTOMER
RA ON DUTY
RD ON DUTY
RESPONDENT
WITNESS
Employee ID:
First Name:
Middle Name:
Last Name:
Home Address:
City
 /
State
 /
Zip Code:
 /
Country
 ,
 ,
,
Home Phone:
Mobile Phone:
Email Address:
Email report to this address
Confirm Email:
Employer Name:
Work Address:
City
 /
State
 /
Zip Code:
/
Country
 ,
 ,
,
Work Phone:
Race:
AMERICAN INDIAN OR ALASKAN NATIVE (I)
ASIAN OR PACIFIC ISLANDER (A)
BLACK (B)
UNKNOWN (U)
WHITE OR HISPANIC (W)
Sex:
FEMALE (F)
MALE (M)
DOB:
April
2024
Driver License Number:
Licensing State:
Person Type
Name
Home Phone
Mobile Phone
Work Phone
Enter Involved Contact Information
Please enter your information as completely as possible. You may be contacted regarding this incident. An email address is required if you would like to be notified when this report is received and approved.
Person Type:
(BOD) BRASS ON DUTY
BYSTANDER
COMPLAINANT
OFFICER, BACKUP
OFFICER, COMM
OFFICER, PRIMARY
PARKING CUSTOMER
RA ON DUTY
RD ON DUTY
RESPONDENT
WITNESS
Employee ID:
First Name:
Middle Name:
Last Name:
Home Address:
City
 /
State
 /
Zip Code:
/
Country
 ,
 ,
,
Home Phone:
Mobile Phone:
Email Address:
  
Email report to this address
Confirm Email:
Race:
AMERICAN INDIAN OR ALASKAN NATIVE (I)
ASIAN OR PACIFIC ISLANDER (A)
BLACK (B)
UNKNOWN (U)
WHITE OR HISPANIC (W)
Sex:
FEMALE (F)
MALE (M)
DOB:
Driver License Number:
Licensing State:
Person Type
Name
Home Phone
Mobile Phone
Work Phone
Enter Incident Information
Please enter all the information that applies. If you do not know the address of the incident, use the nearest intersection such as Market St./ 10th St. Please ignore previous instructions. LB
Street Address:
City
 /
State
 /
Zip Code:
/
Country
 ,
 ,
,
Incident Time (start):
Incident Time (end):
Have Vehicle Info to Enter?:
Yes
No
Have Property Info to Enter?:
Yes
No
Have Digital Media to Enter?:
Yes
No
Origin of Threat:
Incident Description:
(Characters Left)
Enter Vehicle Information
Please enter the Vehicle information.
Type:
CAR
CROSSOVER
ELECTRIC
FULL-SIZE VAN
HYBRID
MINIVAN
MOTORCYCLE
SUV
TRUCK
Make:
ACURA
ALFA ROMEO
ASTON MARTIN
AUDI
BENTLEY
BMW
BOSS HOSS
BUGATTI
BUICK
CADILLAC
CHEVROLET
CHRYSLER
CUSHMAN
DAEWOO
DATSUN
DODGE
DUCATI
EAGLE
FERRARI
FIAT
FORD
FREIGHTLINER
GEO
GMC
HARLEY DAVIDSON
HONDA
HUMMER
HYUNDAI
INDIAN
INFINITI
INTERNATIONAL
ISUZU
JAGUAR
JEEP
JOHN DEERE
KAWASAKI
KENWORTH
KIA
KYMCO
LAMBORGHINI
LAND ROVER
LEXUS
LINCOLN
LOTUS
MASERATI
MAZDA
MERCEDES BENZ
MERCURY
MINI
MITSUBISHI
NISSAN
OLDSMOBILE
PETERBILT
PEUGEOT
PLYMOUTH
POLARIS
PONTIAC
PORSCHE
RANGE ROVER
ROLLS ROYCE
SAAB
SATURN
SCION
SMART CAR
SUBARU
SUNL
SUZUKI
TESLA
TOYOTA
TRIUMPH
VOLKSWAGEN
VOLVO
YAMAHA
Model:
Year (YYYY) :
Color:
ALUMINUM
BEIGE
BLACK
BLUE
BROWN
COPPER
GOLD
GRAY
GREEN
IVORY
LAVENDER
MAROON
ORANGE
PINK
PURPLE
RED
SILVER
TAN
TURQUOISE
UNKNOWN
WHITE
YELLOW
License Plate Type:
COMMERCIAL
GOVERMENT
MOTORCYCLE
PASSENGER
License Plate Number:
(do not enter spaces)
Licensing State:
VIN:
(do not enter spaces)
Insurance Company Name:
Insurance Policy #:
Insurance Policy Expiration Date:
Enter Property Information
Please enter the Property information.
OwnerShip:
COMPANY
LOANED/BORROWED
PERSONAL
Type:
APPLIANCES
ATHLETIC EQUIPMENT
BACKPACK/SHOULDER BAG
BICYCLE
BOOKS
BOTTLES/MUGS/CUPS
CELL PHONE/MOBILE DEVICE
CLOTHING
COMPUTER/LAPTOP
ELECTRONICS
EYEGLASSES
HANDBAG/PURSE
JEWELRY
KEYS
LUGGAGE
MONEY/CREDIT CARDS
MUSICAL INSTRUMENT
NOTEBOOKS/FOLDERS
OTHER/NOT LISTED
POWER EQUIPMENT
TOOLS
WALLET
WATCH
WEAPON
Subtype:
Brand:
Model:
Color:
BLACK
BLUE
BROWN
GRAY
GREEN
ORANGE
PINK
RED
SILVER
WHITE
YELLOW
Serial Number:
How Many:
Approx. Market Value ($):
Property Description:
Select Digital Media
Please select any digital media (pictures, documents or any digital data files) up to 2047 MB that are relevant to this incident.
File Name
Title
Description
Review Report
Please review the report. If all the information is correct, click the Continue button to submit the report. If you need to modify some information, click the desired modify link. This will be your last chance to change information for this report.
General Information:
Incident Type(s):
Reporting Person/Involved Contact Information:
Incident Information:
Incident Location:
Incident Time (start):
Incident Time (end):
Origin of Threat:
Incident Description:
Vehicle Information:
Type:
Make:
Model:
Year (YYYY):
Color:
License Plate Type:
License Plate Number:
Licensing State:
VIN:
Insurance Company Name:
Insurance Policy #:
Insurance Policy Expiration Date:
Property Information:
OwnerShip:
Type:
Subtype:
Brand:
Model:
Color:
Serial Number:
How Many:
Market Value($):
Property Description:
Digital Media:
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