On-Line Crime Reporting Form

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	On-Line Crime Reporting Form Type of crime Preliminary Information First Name MiddleName Last Name Victim's Name (If different) Physical Address Physical Address (2) City Mailing Address Mailing Address (2) City Home Tel No. Business Tel No. Location/Town Crime Occurred Between Description of Crime Description of Property Stolen State Zip State Zip Age Day Year Approximate Time Month E-mail Address* Date of Birth Gender --------------------------------------------------------------- Crime Details ------------------------------------------- FemaleMale The Placer County Sheriff's Department accepts crime reports on-line. If you are the victim of a crime that occurred within the County of Placer, you can submit your initial report here for follow-up by one of our Deputies. This form should only be used for non-emergency type reports. If you wish to report an emergency or urgent incident, please call 9-1-1. Please fill in the form as completely as possible so that we can start your investigation. You will be contacted by a Deputy to follow-up on the information provided. Thank you for your continued support ! Day Year Approximate Time Month In order to expedite your case, please provide the approximate value and serial numbers for each item stolen along with the description --------------------------------------------------------------------------------------------------------------------- Involved, how: BurglarizedDriven by Suspect License No. Vehicle Type Year - Make - Model If there was a vehicle involved, please provide the following information: Availability Colors If a suspect is located, can you return to the Placer County area for Court Would you be able to identify a suspect in a photo or physical line-up Can you make apositive identification of your missing property NoYes Is this report for insurance purpose only ? NoYes NoYes NoYes