| *
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(ex: 8/25/2005 or a range 8/26 - 8/27) |
| *
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(ex: 1:00PM to 9:00PM) |
| *
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(ex: 123 MAIN ST) |
| *
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(ex: CAMERON PARK) Contact City of Placerville or South Lake Tahoe if occurred within their city limits. |
| *
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(ex: JOHN DAVID SMITH) |
| *
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(ex: 11/25/1975) |
(If Applicable) |
(ex: PHIL'S TREE FARM) |
| *
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(ex: PO BOX 1234) |
| * |
(ex: 550 VALLEY ST) |
| *
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(ex: SHINGLE SPRINGS, CA 95682) |
| *
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(ex: 530-676-0000) |
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(ex: 530-677-0000) |
| *
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(ex: example@gmail.com) |
*
Please be as specific as possible. Describe exactly what happened.
PLEASE NOTE: Your description will be included (word for word) in the permanent official narrative of your report. Please pay attention to your spelling and punctuation. |
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| *
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(ex: FRONT YARD, STREET, HOUSE, etc.) |
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(ex: Driver side window was smashed.) |
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* Property Taken / Lost/ Damaged:
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NOTE: The value entered is the value of the item stolen, amount of damage, or cost of repair. For example, a broken windshield on your car is not $21,000. $300 would be more reasonable.
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| * Vehicle Involvement |
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| * |
(ex: 3SAM123) |
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(ex: TOYOTA) |
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(ex: TACOMA) |
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(ex: TRUCK) |
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(ex: 2005) |
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(ex: BLUE) |
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LAST STEP (This prevents automated form submission.)
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