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Incident Report Request Form
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Incident Report Request Form
To request an incident report please enter the report number (ex. 18-00XXX) or 2 of the following: Name, Date/Time of Incident, or Location. Please note that the Incident Type is a required field. Please provide as much information as possible
Incident Type
*
-- Select One --
Assault
Burglary
CCW
Damage to Property
Domestic Violence
Theft
Other
Please select one of the following. If none of the selections apply to your particular case, please select "Other" and complete the field provided.
Other
Report Number (18-00XXX)
First Name
Last Name
Incident Location
Date / Time
Date / Time
Date / Time
Requestor's Contact Information
Please complete one or more of the following:
Phone Number
*
Fax Number
Email Address
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