Your Name:                     

Your Physical Address:         

Your Mailing Address:          

Your Zip Code:                 

Your Home Phone Number:        

Your Work Phone Number:        

Your e-mail Address:           

Your Sex:                      

Your Race:                     

Your Date of Birth:            

Your Age:                      

What kind of crime are you reporting? Please check one:

Date Crime Occurred:           

Time Crime Occurred:           

Location of Crime:             

Victim Name (If not you):      

Description of Crime:

Point of Entry:                
(door, window, wing vent, etc.)

Where Occurred:                
(back yard, driveway, side yard, etc.)

Please describe the property that was stolen from you. Include values of stolen property and serial numbers whenever possible.

Description of Property Stolen:

Please describe any suspects in as much detail as possible. Include such information as height, weight, build, age, race, colors of eyes and hair, facial hair, tattoos, scars, unusual clothing, etc.

Description of Suspects:

If a vehicle was involved in the crime you are reporting, you can use this form if it was broken into or if it belongs to a suspect. If the car was STOLEN, please report it by calling 508-892-7009. If you are reporting vehicle involvement, was it:

Vehicle License Number:        

Vehicle State:                 

Vehicle Make:                  

Vehicle Model:                 

Vehicle Type:                  

Vehicle Year (or approx range) 

Vehicle Colors:                

When we receive your on-line report, we will: 1) assign it a Report Number 2) send you the number and a copy of your report via e-mail within two working days and 3) screen your report for potential investigation. When you receive this message, you should print it out and save it for insurance purposes. If you would like to give us any comments about our on-line crime reporting system, please add them below:

Additional Comments:

Thank you for participating in our new on-line crime reporting system. This 
system (as well as others) is under constant evaluation to make sure it meets 
the community's needs as much as possible. If you have suggestions for other 
on-line services that would be of value to you, please send us an e-mail and let us 
know , please do not forget to SEND this Crime Report.