Online Crime Report

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:


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

    This field is not part of the form submission.

55. Submit

* indicates a required field