Online Crime Report

2. Type of Report*
   -- Select One --Harassment By PhoneInternet CrimeLost PropertyTheft (Under $500.00)Vandalism

3. Date Incident Occurred*
   Date Incident Occurred

   Date Incident Occurred

   Please fill out this field

5. 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. You do not know the serial number(s) of the stolen property
   6. This does not involve identity theft

9. Submitter Information

11. First Name (Your Information)*

    Please fill out this field

12. Last Name*

    Please fill out this field

14. Street Number*

15. Street Name*

16. Street Type

17. Apt #

19. City*

20. State*

21. ZIP Code*

23. Sex*

    1. Female
    2. Male

24. Date of Birth*
    Date of Birth

25. Home Phone*

26. Work Phone

28. 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

32. PROPERTY INFORMATION

34. Vehicle Year

35. Vehicle Make

36. Vehicle Model

37. Vehicle Plate #

39. Lost, Stolen or Damaged Property Description

40. Quantity

42. Model

43. Serial Number

44. Value*

46. Additional Property Involved

    List additional property involved in same format as above, to include plate or serial number and value

50. Statement of Events*

Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field