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2. Today's Date*
   Today's Date
3. Date & Time of Offense*
   Date & Time of Offense

   Date & Time of Offense
5. Offense Location*
7. If Other, Please Explain
9. Details of Offense*
11. How do you know this information?
13. Are you the victim?*

    1. Yes
    2. No
14. Name of reporting party*
15. Phone Number of reporting party*
17. Name of victim*
18. Address of victim*
20. Phone of victim*
21. Email of victim
25. Suspect 1
27. Name
28. Alias
30. Address
32. Gender

    1. Male
    2. Femal
33. Race
    -- Select One --African AmericanAsianCaucasianHispanicNative American
34. Age
    -- Select One --Under 1818 - 2930 - 3940 - 4950 - 5960 and Over
36. Height
37. Weight
39. Hair Color
40. Eye Color
42. Scars / Marks / Tattoos
44. Vehicle Color
45. Make
47. Model
48. Year
50. Plate Number
51. Distinguishing Characteristics
53. More Information
57. Suspect 2
59. Hair Color
60. Eye Color
62. Plate Number
63. Distinguishing Characteristics
65. More Information
69. Suspect 3
71. Hair Color
72. Eye Color
74. Plate Number
75. Distinguishing Characteristics
77. More Information
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79. 1. Receive an email copy of this form.
80. Email address

    This field is not part of the form submission.

81. Submit

* indicates a required field