2. Description of Location Involved
   (On Street, House, Apartment, Business, Park)
4. Address1
6. Address2
8. City
9. State
10. Zip
12. Color of Building
14. Suspect's Telephone Numbers
16. Suspect(s)
18. 1. Suspect Name, Age / DOB, Sex, Race, Height, Weight
20. 2. Suspect Name, Age / DOB, Sex, Race, Height, Weight
22. 3. Suspect Name, Age / DOB, Sex, Race, Height, Weight
24. 4. Suspect Name, Age / DOB, Sex, Race, Height, Weight
26. Vehicle(s)
28. 1. Vehicle
    (Year, Make, Model, Color, License, State, Other Identifying Damage, Stickers, etc.)
30. 2. Vehicle
    (Year, Make, Model, Color, License, State, Other Identifying Damage, Stickers, etc.)
34. Type of Drug(s) / Gambling Suspected
35. Quantity
37. Method of Operation
38. Days & Hours of Operation
40. Sell to / Gambling With
    -- Select One --AnyoneOnly people they knowUnknown
42. Selling From
    -- Select One --UnknownHole in door or wallDirect to customerOther
43. Specify if "Other":
45. Buyer Approach
    -- Select One --Front doorPorchRear doorSide doorOther
46. Specify if "Other":
48. Additional Comments
52. Source of Information
54. The identity of persons reporting suspected drug / gambling activity is kept in the strictest confidence. Would you be willing to speak to a detective about your information?

    1. Yes
    2. No
56. First Name
57. Last Name
59. Email
60. Phone
Leave This Blank:


62. 1. Receive an email copy of this form.
63. Email address

    This field is not part of the form submission.

64. Submit

* indicates a required field