Law Enforcement
Suspicious Activity Reporting

Submitter's First Name:*

Submitter's Last Name:*

Agency / Organization Name:*

Best Contact Number: (###) ###-#### *

Email Address: *


Incident Date:*(mm/dd/yyyy)   Time:    (e.g. 10 pm) 

Description of Activity: *
 Breach/Attempted Intrusion
 Misrepresentation
 Theft/Loss/Diversion
 Sabotage/Tampering/ Vandalism
 Cyber Attack
 Expressed or Implied Threat
 Aviation Activity
 Eliciting Information
 Testing or Probing of Security
 Recruiting
 Photography
 Observation/Surveillance
 Materials Acquisition/Storage
 Acquisition of Expertise
 Weapons Discovery
 Sector-Specific Incident
 Officer Safety
 Regional Crime Trends
Other (describe below)


Brief summary: *


Case or Incident Number: 


Name of Subject(s):(If available)  

Subject Identification: (DOB; Drivers License #; Phone Numbers)

Incident Location - Street Address or Cross Streets: *

City:*

State:*


Please attach police reports and photos: (combined limit 10 MB)







Optional Information

Secondary Contact Name:(if applicable)

Alternate Contact Number:(###) ###-####  (if applicable)

Alternate Email Address:(if applicable)