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Citizen Self Reporting Incident Form

  1. I have read the above conditions*

  2. Are there any suspects in this incident? (If the answer is YES you cannot submit online and should call 911 to make the report)*

  3. Sex*

  4. The property was...*

  5. Amount of Loss*

  6. This property was...

  7. The property was...

  8. The property was...

  9. IMPORTANT: Did you consent to this crime?*

  10. I understand that this Citizen Self Report form will be filed with the Superior Police Department. I attest that I have read and understand the instructions for completing this police report. I also attest under penalty of law that information and statements made herin are true and correct to the best of my knowledge.*

  11. Leave This Blank:

  12. This field is not part of the form submission.