Wapakoneta Police Department

General Crime Information Form

Please include as much information as possible in the form below. Incomplete or inaccurate information will delay processing of this report and may compromise our ability to quickly and effectively respond to this complaint. Thank you.

Please Note:
All fields marked with an asterisk (*) are required and must be completed in order to proceed.

1. Please tell us where the problem is

The address must be entered correctly for the report to be processed.

Address *

Address 2 or Apartment #

2. Please select where the activity occurs at the above location

Identify the activity location for this violation, please select only one. *

Inside Business	Sidewalk/Street Corner
Inside Private Residence	Vacant Lot
Alley or Driveway	Vehicle
Hallway/Corridor	Garage
Park/Wooded Area	Other Activity Location

If "Other" is selected, please specify

3. Please tell us about the activity

Days when activity is present? *

Select all that apply, do not exaggerate - we will be using this information to verify the report.

Monday	Friday
Tuesday	Saturday
Wednesday	Sunday
Thursday	Do Not Know

Times when activity is present? *

Select all that apply, do not exaggerate - we will be using this information to verify the report.

12am - 2am	2pm - 4pm
2am - 4am	4pm - 6pm
4am - 6am	6pm - 8pm
6am - 8am	8pm - 10pm
8am - 10am	10pm - 12pm
10am - Noon	Infrequently
Noon - 2pm	24 hours a day
	Do Not Know

Describe the activity *

Use this area to tell us about the activity being reported. Explain as much in detail about the situation as you can. Remember, you can't tell us too much!

4. Please tell us about the Offender

If you know the Offender's name, description, current address or phone number, please provide it below.

Offender's Name
If you know the Offender's name please provide it below.

Offender's Nickname
If you know the Offender's nickname please provide it below.

Offender's Age
Enter the approximate age of the primary age of the Offender at this location. You may enter an age range. ie: 20-25 years.

Offender's Race and Sex
Please enter the race and sex of the primary Offender below.

Offender's Phone Number
If you know the primary Offender's phone number enter it below.

Offender's Pager Number
If you know the primary Offender's pager number enter it below.

Offender's Address
If you know the address of the violator enter it below.

City / State / Zip Code
If you know the Offender's city, state and zip provide this below.

Offender's Description
Please describe the violator's appearance. Include scars, tattoos, clothes, jewelry descriptions, hair styles and any other distinguishing marks. If you can't provide a description enter "Unknown" in this space.

5. Please tell us about any vehicle used by the participants

Use this area to tell us about any vehicles used by the participants of this activity.

Vehicle Type

Vehicle Year

An approximate year is acceptable, if it's a newer car please mention that.

Vehicle Manufacturer

For example, Ford, Chevrolet, Honda, Cadillac

Vehicle Model Name

For example, Escort, Camaro, Civic, El Dorado

Vehicle Color

For example, Green, Light Green, Dark Green

License Plate State

If you don't know the state, please describe the color.

License Number

If you only know part of it, please enter it.

Unique Features

Describe any unique features like damaged parts, accessories, sun roofs, etc. The idea is to give us a unique description of the car so we can immediately recognize it.

6. Please tell us about yourself

This area is completely optional. You do not have to provide this information to us. If you decide to, we will use it only to contact you for additional information. This information will be kept strictly confidential.

Your Name

Street Address

Address 2 or Apartment #

City & State

Zip Code

Daytime Phone

May we call you for additional information?

Yes No

Email Address

Additional Comments