Single Family
Duplex
Four Family
Apartment Building
Rental Property
Garage
Commercial Building
|
 |
Upper
Lower
Front Yard
Back Yard
Front Porch
Back Porch
|
|
Guns on Premises:
Yes
No
Don't Know
|
|
Dogs on Premises:
Yes
No
Don't Know
|
|
|
Type of Incident:
(Required)
|
Drug House
Street Drug Dealing
Type of drugs, if known.
Gang Activity
Name of gang, if known.
Shooting/Gun Shots
Mugging/Assault
Child Abuse/Neglect
Home Break In
|
|
Garage Break In
Auto Theft
Auto Break In
Public Drinking
Loitering/Trespassing
Panhandling
Street Gambling
Vandalism
Graffiti
Loud Party/Music
Loud Car Stereo
|
Description/Names of Participants of Above Incident
Describe age, race, height, weight, hair color/length, facial hair, tatoos, clothing/hats, etc.
|
|
Abandoned Auto on Street
|
|
Abandoned Auto on Private Property
|
Description of Above Auto
License plate number, type of vehicle, year/make/model, color, number of doors, damage, etc.
|
Uncut Grass/Weeds
Building Code Concern
|
|
Unshoveled Snow
Street Light Out
|
Description of Above Building Code Concern
|
|
|
Have Authorities Been Previously Notified of This Incident?
|
Yes
No
|
|
If Yes, when?
|
|
|
Have You Reported Other Incidents at This Property in the Last 30 Days?
|
Yes
No
|
|
|
Do You Wish to Be Contacted by Authorities for Follow-Up?
|
No, I'll Remain Anonymous
Yes, Contact Me
|
