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Sedgwick County Sheriff
 

Sedgwick County Sheriff's Office
Suspicious Activity Report Form
This is not an official police report.
To report a crime or emergency please call 911.

Please provide the following contact information about yourself:

First name: 
Last name: 
Street address: 
Address (cont.): 
City: 
State: 
Zip/Postal code: 
Work Phone: 
Home Phone: 
E-mail: 

Please identify the individuals involved in the incident. Note: Please identify, to the best of your ability, what role the person played in the incident using the drop down menu, labeled "Role"

Individual #1
First name
Last name
Date of birth
Sex Male Female
Race:
Height:
Weight:
Hair Color:
Eye Color:
Role:
Individual #2
First name
Last name
Date of birth
Sex Male Female
Race:
Height:
Weight:
Hair Color:
Eye Color:
Role:

Individual #3
First name
Last name
Date of birth
Sex Male Female
Race:
Height:
Weight:
Hair Color:
Eye Color:
Role:

Individual #4
First name
Last name
Date of birth
Sex Male Female
Race:
Height:
Weight:
Hair Color:
Eye Color:
Role:

Please provide any known vehicle information (including auto tag numbers) of  the individual's involved in the activity.

 
Vehicle #1
Make:
Model:
Color:
Year:
Tag: include state
 
Vehicle #2
Make:
Model:
Color:
Year:
Tag: include state
 
Vehicle #3
Make:
Model:
Color:
Year:
Tag: include state
 
Vehicle #4
Make:
Model:
Color:
Year:
Tag: include state

Enter the date/time and location of the incident:

Date (mm:dd:yy) Time (hh:mm - am/pm):

Location of Incident (Address):

City: State:

You may contact me regarding this matter.

Voluntary Statement: Please describe the circumstances of the incident. Please be as specific as possible, not leaving out any detail. Tip: It is easier to describe a situation by using the Who, What, Where, When, Why, and How format.


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last update: 04/27/02
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