Section I – Incident Type

Vandalism (Excluding Graffiti)HarassmentBurglary or Theft (No Suspect Information and No Property has no identifiers (s/n)

Brief Description:

Section II – Reporting Party Information

Full Name:
Sex
Race:
Date of Birth:
Address:
City:
State:
Zip code:

Business Name:
Business Address:
City:
State:
Business zip code:
Telephone:HomeWorkCell

Section III – Victim Information

I am also the Victim (If you are the Victim, skip to Section IV, otherwise, please fillout this section)

Name:
Sex:
Race:
Date of birth:
Age:
Address:
City:
State:
Zip:
Telephone:HomeWorkCell

Section IV – Incident Information

Location where crime happened (full address):
If this is a business, what is the business name:
The crime happened on (date):
Time:
Or between (dates:
and:

Section V – Property and/incident Description
Brief Description:

I confirm that the incident occurred within the City of El Centro, CA
Submit e-Report