AS
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Date of Incident
When did the incident occur?
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DD
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YYYY
What was the location of the incident? *
Enter the street address, city, state and zip code
What type of incident was it? *
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Description of Incident
Tell us about what happened
Officer Gender
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Office Race/Ethnicity
What is the officer's ethnicity/race?
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Other Officer Information
Enter officer badge number, license plate number, etc
Officer 2 Gender
If there was a second officer, enter officer information here
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Officer 2 Race/Ethnicity
If there was a second officer, enter officer information here
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Multiple officers
If there were more than two officers involved, please enter information here
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