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Date and time of occurence:
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Note: The following information is confidential.
Reporting Person Information
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Name:
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Address:
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City, State, Zip
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Home Phone:
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ie. (913) 123-4567
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Work Phone:
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ie. (913) 123-4567
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Email:
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Information for additional witness
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Name:
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Address:
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City, State, Zip:
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Home Phone:
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(913) 123-4567
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Work Phone:
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ie. (913) 123-4567
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Suspect Information
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Name:
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Address:
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City, State, Zip:
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Home Phone:
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ie. (913) 123-4567
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Work Phone:
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ie. (913) 123-4567
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Race:
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Sex:
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Age:
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Height (ie 5'6"):
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Weight:
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Hair:
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Eyes:
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Marks, Scars, Tattoos, Deformities:
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Suspect Vehicle Information
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License Number:
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License State:
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License Year:
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License Type:
(ie: car, truck)
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Vehicle Identification Number:
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Color:
(ie white/white)
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Make:
(ie chev, ford)
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Model:
(ie 2dr, 4dr)
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Year:
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Describe the complaint:
Describe in as much detail as you can the nature of the suspicious activity,
for example, domestic violence, drugs, theft, etc.
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