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3. 
7. Citizen Drug Complaint Form
11. Occurrence Detail
13. Date & Time*
    Date & Time

    Date & Time
15. Location*
    If the street address is unknown, please provide detailed information about the house description and location
19. If this is an ongoing problem, please identify the time of day or days of the week the drug transactions occur more frequently
21. What drugs were involved*

    1. Heroin
    2. Cocaine
    3. Marijuana

    1. Prescription Pills
    2. Ecstasy
    3. Methamphetamine

    1. Other
    2. Unknown
25. Suspect Characteristics
27. Name
28. Sex
30. Race
31. Age
32. Build
34. Height
35. Weight
36. Eye Color
37. Hair Color and Style
41. Vehicle Involved
43. Make
44. Model
45. Color
47. License Plate & State
48. Other Info (Stickers, Decals, Etc.)
52. Additional Information
54. Have you observed any weapons*

    1. No
    2. Yes
55. If yes, what type
57. Does anyone act as a lookout or are surveillance cameras used*

    1. No
    2. Yes
    3. Unknown
59. Any additional information about viewed drug sales
63. Complainant Information (Not Required)
65. Name
66. Phone Number
68. May we contact you to obtain additional information, if needed?

    1. No
    2. Yes
Leave This Blank:


70. 1. Receive an email copy of this form.
71. Email address

    This field is not part of the form submission.

72. Submit

* indicates a required field