Reynoldsburg Division of Police 7240 East Main Street Reynoldsburg, Ohio 43068 Telephone (614) 866-6622 / Fax (614) 322-6997
SELF REPORTING FORM INST...
Reynoldsburg Division of Police 7240 East Main Street Reynoldsburg, Ohio 43068 Telephone (614) 866-6622 / Fax (614) 322-6997
SELF REPORTING FORM INSTRUCTIONS This form may be used to file the following official police reports if no prosecution is warranted or the SUSPECTS ARE UNKNOWN AND the IMM EDIATE PRESENCE OF A POLICE OFFICER is not needed: Type of Crime
Description
Section Number
Criminal Damaging/Mischief
Damages done to property
541.03/541.04
Petty Theft
Theft of items, total value at less than $500 (excluding stolen checks or credit cards)
545.05
Criminal Trespass
Trespass on another’s property or business
541.05
Unauthorized Use of Property
Does not include vehicles
545.08
Telecommunications Harassment
For first time incidents and/or when no trace has been made by the reportee/victim
537.10
Unnecessary Noise
Noises that are unusually loud or at an unreasonable time
509.11
Barking or Howling Dog or other Animal
Habitual problems with barking dog or other animal in neighborhood
505.19
Animals Running at Large
Animals running loose in neighborhood without the owner’s supervision
505.03
Suspicious persons (if person(s) still in area call None for an officer to be sent), solicitor complaints (if person(s) still in area call for an officer to be sent), civil matters such as child custody disputes, and lost items (not including license plates, checks or credit cards) ____________________________________________________________________________________ ALL BLANKS MUST BE COMPLETELY FILLED OUT AND LEGIBLE or the form may not be accepted. The form must be SIGNED by the person making the report. Be as complete as possible when describing the crime. A complete description of each City Ordinance can be found on our website at www.ci.reynoldsburg.oh.us. If the crime results in the theft or destruction of property, please estimate the dollar value of the loss. This report will be maintained in the Records Section of the Reynoldsburg Division of Police. Copies may be obtained at the Records Section counter, Monday-Friday, 8:00 a.m.4:00 p.m. Information Reports
Revised 06/2006
Reynoldsburg Division of Police 7240 East Main Street Reynoldsburg, Ohio 43068 Telephone (614) 866-6622 Fax (614) 322-6997 __________________________________________________________________________________
OFFICIAL POLICE REPORT Self-Reporting Short Form Police Use Only
Date Filed:
Police Use Only
Event#:
Police Use Only
Report#:
Type of Crime: (see chart on instruction page) ___________________________________________________Section Number_________________ Date when crime occurred:
Time when crime occurred:
Between_______________and ______________
Between_______________and ______________
Address where crime occurred:
Name of victim or business name: Complete address with city, state, zip: Phone number: Alternate phone number: Social Security Number/Date of Birth:
/
Name of person completing this report: (YOU MUST BE 18 years old or older) Complete address with city, state, zip: Phone number: Alternate phone number: Social Security Number/Date of Birth: Are there any witnesses? If so, name below. ________________________________________ ________________________________________
/ Telephone number or address of witnesses: ________________________________________ ________________________________________
Revised 06/2006
Are there any suspects? If so, describe here.
If suspect is known to you, contact police to file report. DO NOT FILE this form.
If this is a theft report, describe property stolen:
Item________________________________________Value$_________ Attach a piece of paper for Identifying Number___________________________Quantity________ additional items. Item________________________________________Value$_________ Identifying Number___________________________Quantity________ Description of what happened: (use additional sheets if necessary)
I hereby affirm that the facts contained in this Official Police Report are true to the best of my knowledge. I understand that making a false police report is a crime and is punishable by fines and or imprisonment. _____________________________ ______________ Signature Date Supervisor Signature:
Date:
Follow-up: Y
N
Reynoldsburg Division of Police Mission Statement The Police and Community in a cooperative effort will work to promote a safer Reynoldsburg through education, prevention and enforcement.
