Police Department
Online Reporting:
Bicycle Incident
Back to Instructions
Step 1:
Required fields are marked with *
Personal Information (person filing report):
*Last Name
*First Name
Middle Name
*Mailing Address
*City
*State
*Zip Code
Choose One:
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces Africa
Armed Forces Americas
Armed Forces Canada
Armed Forces Europe
Armed Forces Middle east
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*Phone
( XXX-XXX-XXXX )
Alternate Phone
( XXX-XXX-XXXX )
E-Mail
Driver's License #
State DL Issued
*Date of Birth
( MM/DD/YYYY )
Choose One:
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces Africa
Armed Forces Americas
Armed Forces Canada
Armed Forces Europe
Armed Forces Middle east
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*Gender
Race
M
F
Choose One:
American Indian
Asian Indian
Black
Cambodian
Chinese
Decline to Answer
Filipino
Guamanian
Hawaiian
Hispanic
Japanese
Korean
Laotian
Other
Pacific Islander/Tongan
Samoan
Unknown
Vietnamese
White
*Victim Name (may be a person or business name)
Step 2:
Required fields are marked with *
Crime Specific Information:
Please enter the information related to the incident or crime.
*Location
( include street address if possible )
*City
*State
California
*Date of Occurrence Range
( MM/DD/YYYY )
Please list the dates that the crime occurred between ( ie. 02/20/2003 to 02/25/2003 )
to
*Time of Occurrence Range
( HH:MM AM/PM )
Please list the times that the crime occurred between ( ie. 08:15 PM to 01:00 AM )
to
*Describe what happened
( Be specific )
Was any evidence left behind? (ie: tools, fingerprints etc.) If yes, please describe:
IMPORTANT:
Please review all information entered and make sure that it is true and correct. Please also make sure all fields marked with an asterisk (*) are filled in as these are
REQUIRED
fields.