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File a Non-Emergency ("Cold") Criminal Report

2. Location of Activity*

4. Date & Time it Happened*
   Date & Time it Happened

   Date & Time it Happened

6. Describe Activity*

8. List Any Damaged/Destroyed Proprty

   Please include detailed description, serial numbers, and value for each item.

10. Do you suspect a specific person?*

    1. Yes
    2. No

12. If yes, who?

14. Your Name*

15. Date of Birth*

    mm/dd/yyyy

17. Address

19. City

20. State

21. ZIP

23. Email*

24. Phone*

26. Best Time to Reach You
    Best Time to Reach You

28. Any Other Comments

Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field