Type of Crime: Crime Date:

Address :

Victim's Name:

Description of Crime: (Please include Who, What, When, Where and How Do You Know):

Are there drugs involved? Yes No Unknown

If yes, what type of drugs are involved?

If drugs are sold, tell us how: Select Quantities Packaging Joints Baggies Bulk

How are they being sold? (from residence, vehicle, etc.)

Are there any weapons involved? Yes No

Do the suspects have any dogs? Yes No

Is the suspect or suspects involved in gangs? Yes No

If you answered yes to the above question, Please enter any information you have about the particular gang, the Name of the gang, their gang hangouts, and any other illegal activity that the gang may be involved in.

Name: Alias/Nickname:

Address:

Race: Select Asian Black Hispanic White Other Gender: Select Female Male Unknown

Height: Weight: Age:

Hair Color: Hair Style: Eyes:

Does suspect have any distinguishing marks? (i.e. tattoos, scars, etc.) :

Name: Alias/Nickname:

Address:

Race: Select Asian Black Hispanic White Other Gender: Select Female Male Unknown

Height: Weight: Age:

Hair Color: Hair Style: Eyes:

Does suspect have any distinguishing marks? (i.e. tattoos, scars, etc.) :

Make: Model: Year:

Color: License: State:

Are you willing to submit additional information if it becomes available to you? : Yes No

Your Name:

Email: Phone: