The form below is provided for you to present a detailed itemized list of items taken during your recently reported theft.
Please complete the following portions of the form before returning it to the officer who took your initial report. If you do not complete this step your police report will not be considered complete.
The following boxes MUST be filled in:
Case # (you were assigned a case number by the officer when you requested your police report)
Victim name, address and phone number
Below are examples to assist you in completing this form to the best of your ability:
Qty: Number of this item taken
Item: What the item is (example: I-pod)
Serial Number: Include if you can (example: 212187955, usually on the paperwork you recieved with your item)
Brand: Specific Brand (example: Apple)
Model: Specific Model (example: Nano)
Size: Specific Size (example: 8 gig)
Color: Primary color(s)
OAN: Any Owner Applied Number (example: you created your own number for your records OR1234567)
Location: Specific location (example: in center console of car)
Status: What happened to the item stolen
Loss: Value Replacement cost (please be as close as possible)
Once completed please return this form to the Police deparment as soon as possible, attention your referring officer.
If you have any question, please contact the police officer that assisted you with placing your police report initially.