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Suspicious Activity Report

SUBMITTERS INFORMATION

Submitter's First Name: *

Submitter's Last Name: *

Agency / Organization Name: *
(If you are not affiliated with a government agency please click other)

Location/Assignment

Best Contact Number: *

Mobile Number:

Work Email Address: *

Your TLO Coordinator's E-mail Address (if available):


INCIDENT INFORMATION

Incident Date:(mm/dd/yyyy) * Time: (e.g.2200) 
  
Incident Location - Street Address or Cross Streets:
City: County:
 

Case or Incident Number (If known):


Description of Activity: *
Breach/Attempted Intrusion
Misrepresentation
Theft/Loss/Diversion
Sabotage/Tampering/ Vandalism
Cyber Attack
Expressed or Implied Threat
Aviation Activity
Eliciting Information
Testing or Probing of Security
Recruiting
Photography
Observation/Surveillance
Materials Acquisition/Storage
Acquisition of Expertise
Weapons Discovery
Sector-Specific Incident
Officer Safety
Human Trafficking
Regional Crime Trends
Other (describe below)


Disposition:*
 For situational awareness only, submitting agency is handling
 Request follow-up by appropriate agency

Incident Summary: *


SUBJECT INFORMATION
(For additional subjects please include in summary)

First Name Middle Initial Last Name
  
DOB:(mm/dd/yyyy) Drivers License # State
  
Address - City - State - Zip

Phone Number(s)

E-mail Address(es)/Social Media Links


VEHICLE INFORMATION

ATTACHMENTS

Please attach police reports and photos:(combined limit 10 MB)








Providing false or misleading information is a violation of Federal Law and may be subject to prosecution under Title 18 USC 1001. All information is subject to review and verification.



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