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Request ID:
Work Order Number:

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Date Submited
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Department:
Problem Type:
Type of structure:*
How long has the structure been in this state?
How did you come to know about this narcotic problem?:
Have you made any other complaints on this case, address, or offender?
If so, do you know what law enforcement action was taken?:
When did you make the complaint?:
Would you be interested in working with the police and/or providing information on other narcotic cases/complaints?:
If yes, please provide a telephone number or email address that we may contact you.:
What is the complaint about?:
If other type of complaint, please describe.:
If this is a complaint of distribution, what types and quantities of narcotics are being distributed?:
If the offender is selling, who are they selling too?:
What is the manner of distribution?:
If other, describe other means of distribution.:
Where does the offender keep his/her narcotics:
Full name of offender(s). Include any street names or nicknames.:
Detailed description of offender(s).:
Phone number of offender:
Vehicle description of offender(s). Include year, make, model, license plate number:
Do you know if the offender carries or has access to any weapons?:
If yes, please describe in detail. Specifiy if weapons are hand guns, shotguns, rifles, automatic, semi-automatic, knives, brass knuckles, etc.:
Where is the offender(s) employed?:
If not employeed, where is the offender(s) usually located?:
When is the activity taking place? Please be specific and include day of week and time of day. (eg. Friday nights 9pm until midnight):
Make of Truck
Color
Truck was last seen at location:
Shoes were first seen:
Requst Description:

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