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