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Hit and Run Report

Only use this form to report crimes that occurred in the City of East Palo Alto. If the incident occurred elsewhere, please contact the appropriate agency where the incident occurred.

Please complete as many lines of the report as you possibly can. This will help us investigate the crime that you are reporting and / or screen it for potential investigation. If you only have partial information (like part of a license number, or a person's description), please give us whatever you have!

Please include whenever possible, the serial number, license number, account number (for credit cards and or checks), owner applied number, etc., of the lost or stolen property you are reporting.

If you need to report more than one type of crime or incident, please send us a separate Report Form for each one.

NOTE: If we need additional information to properly file your report, we will ask for this information to be submitted before a report number will be issued, so please fill out the form as completely as possible. Fields with asterisks (*) are MANDATORY - These must be completed for the report to be accepted.

Personal Information:

 Please enter all of your personal contact information.

Your FULL Name:

 *

Your Mailing Address:

 *

Your City and Zip Code:

*

Your Birthdate:

 *

Your Age:

 *

Your Email:

 *

Your Home Telephone:

 *

Your Work Telephone:

Your Drivers Licence #:

Your Drivers License State:

Your Gender:

 Male   Female

Your Race:

 White    Black    Asian    Hispanic
Pacific Islander   American Indian   Other

Victim's Name (If other than yourself):

Victim's Mailing Address (If other than yours):

Location, Time and Date:

 Please describe the crime in as much detail as possible.

Address where Crime / Incident occurred:

 *

Location of hit and run (driveway, street, etc.):

 *

Date(s) when crime / incident occurred or was discovered:

 *

Time(s) when crime / incident occurred or was discovered:

 *

Describe the incident in detail (Tell us what happened) *

Please describe the vehicle involved:

 Include any known information about the vehicle.

Make:

Model:

Color / Color:

Vehicle License:

Vehicle License State:

Registered Owner:
   

 Please contact me.


East Palo Alto Police Department
2415 University Avenue, CA 94303
Tel: (650) 853-3160; Fax: (650) 853-3106
 

Copyright © 2001, City of East Palo Alto.
Please read our Acceptable Use Policy. This page was last reviewed: June 20, 2007