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2. IF THIS IS AN EMERGENCY, DIAL 911
4. Type of Report*
   -- Select One --Harassment By PhoneTheft from a VehicleSuspicious IncidentTrespassingCivil MattersInternet CrimeLost PropertyTheft (Under $1,000.00)Vandalism
5. Date Incident Occurred*
   Date Incident Occurred

   Date Incident Occurred
   Please fill out this field
7. In order to use this form, you must be able to check all the following boxes:*

   1. This is a non-emergency crime
   2. You cannot identify a suspect
   3. The incident occurred within Fort Morgan city limits
   4. You are not reporting a violent crime
   5. No physical evidence was left behind by the suspect
   6. The incident is not traffic related

   1. The amount of loss is less than $1000.00
   2. This is not a misuse of credit or debit card crime
   3. The incident is not related to graffiti
   4. No weapons were stolen
   5. This does not involve identity theft
11. Submitter Information
13. First Name (Your Information)*
    Please fill out this field
14. Last Name*
    Please fill out this field
16. Street Number*
17. Street Name*
18. Street Type
19. Apt #
21. City*
22. State*
23. ZIP Code*
25. Sex*

    1. Female
    2. Male
26. Date of Birth*
    Date of Birth
27. Home Phone*
28. Work Phone
30. Additional Parties Involved
    List victim if different than reporting party and/or witnesses here. Identify if Victim or Witness / First Name / Last Name / DOB / Address / Phone Number
34. PROPERTY INFORMATION
36. Vehicle Year
37. Vehicle Make
38. Vehicle Model
39. Vehicle Plate #
41. Lost, Stolen or Damaged Property Description
42. Quantity
44. Model
45. Serial Number
46. Value*
48. Additional Property Involved
    List additional property involved in same format as above, to include plate or serial number and value
52. Statement of Events*
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field