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Online Police Report
What is your full name?
*
Date of Birth
*
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Date of the incident:
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Time of Incident
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AM
PM
What is your home address?
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What is your phone number?
*
What is your email address?
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What type of crime was committed?
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Fraud
Suspicious Circumstances
Theft
Vandalism
Other
Other
Briefly describe the incident.
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Is there any video footage of the incident?
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Yes
No
Was the incident witnessed by anyone?
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Yes
No
If yes, please provide their name and contact information:
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