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2. Report Type*

   1. Original - This is the first report that is being filed for this incident.
   2. Supplemental - Providing additional information to a prior report
4. Type of Crime
   -- Select One --Hit and run with damage to vehicle or propertyVandalismPast larcenyHarassmentIdentity theftIllegal dumping
6. Original Report Number (if supplemental)
8. Officers Name (if supplemental)
10. Reporting Person Type*

    1. Individual
    2. Business
12. Full Name*
14. Address, City, State, Zip*
16. Best Number To Reach You At*
18. Contact Number

    1. Cell Phone
    2. Home Phone
    3. Business Phone
20. Email Address*
22. Date of Incident
24. Address Where Incident Occurred*
26. Location of Incident*
    -- Select One --ResidentialCommercialGovernmentOther
28. Please Describe the Incident You are Reporting*
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 Submit and Print

* indicates a required field