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Confidential Narcotics Report Form

Please include as much information as possible in the form below.  Incomplete or inaccurate information will delay the processing of this reoprt and may compromise our ablity to quickly and effectively respond to this complaint.  Thank you!
Please tell us where (address) the problem is?
Please tell us about the security at the location?
Please tell us about the activity - nature?
Days when activity is present?
Times when activity is present?
Describe in detail the activity?
Have you seen guns at this location?
Please tell us about the drug dealer or distributor?
Dealers name?
Dealers Nickname?
Dealers Age?
Dealers Race and Sex?
Dealers phone number?() -
Dealers address?
City/State/Zip Code
Vehicles used by dealer/participants - color, make, model, license plate?
Please tell us about yourself? Name, address, phone number. May we call you for additional information? Phone number?
Additional Comments

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