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Confidential Narcotics Report Form

  1. Please include as much information as possible in the form. 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.
  2. 1. Please tell us where the problem is
  3. The address must be entered correctly for the report to be processed, a misspelled or incomplete entry will return a negative response.
  4. 2. Please select where the activity occurs at the location given in section 1
  5. Identify the activity location for this violation*
  6. 3. Please tell us about the security at this location
    Help us determine what we're up against so we can take the necessary precautions. If you don't know, please leave this section blank.
  7. Have you seen guns at this location?
  8. Are there dogs at this location?
  9. 4. Please tell us about the activity
  10. Activity Nature*
  11. Days when activity is present*
    Select all that apply, do not exaggerate - we will be using this information to verify the report
  12. 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!
  13. 5. Please tell us about the drug dealer or distributor
    If you know the drug dealer's name, description, current address or phone number, please provide it.
  14. Enter the approximate age of the primary age of the Offender at this location. You may enter an age range. Example: 20-25 years
  15. 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.
  16. 6. 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.
  17. An approximate year is acceptable, if it's a newer car please mention that.
  18. For example, Ford, Chevrolet, Honda, Cadillac
  19. For example, Escort, Camaro, Civic, El Dorado
  20. If you don't know the state, please describe the color.
  21. If you only know part of it, please enter it.
  22. 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.
  23. 7. 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.
  24. May we call you for additional information?
  25. Leave This Blank:

  26. This field is not part of the form submission.