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Report a Crime

2. Please read each question below.
   You can only use the online reporting if the following criteria are met:<br> 1. The crime must have occurred in the Town of Prescott Valley.<br> 2. The crime did not involve injury to anyone.<br> 3. You do not have any suspect leads (description, license plate number, name of suspect).<br> 4. The crime did not involve the use or threat of a weapon.<br> 5. No physical evidence exists.<br> 6. The crime did not involve someone entering your home, garage or business without your permission.<br> 7. The crime did not involve the theft of a motor vehicle.<br> 8. The value of the lost or stolen item is under $1,000.<br> 9. The lost or stolen item is not a gun.<br> 10. The theft or lost property does not involve prescription drugs.

   You can only use the online reporting if the following criteria are met:
   1. The crime must have occurred in the Town of Prescott Valley.
   2. The crime did not involve injury to anyone.
   3. You do not have any suspect leads (description, license plate number, name of suspect).
   4. The crime did not involve the use or threat of a weapon.
   5. No physical evidence exists.
   6. The crime did not involve someone entering your home, garage or business without your permission.
   7. The crime did not involve the theft of a motor vehicle.
   8. The value of the lost or stolen item is under $1,000.
   9. The lost or stolen item is not a gun.
   10. The theft or lost property does not involve prescription drugs.

4. Victim Type

   1. Person
   2. Business

6. Reporting Persons Information

8. Name of Victim*

9. Date of Birth*
   Date of Birth

11. Address*

13. City*

14. State*

15. Zip Code*

17. Home Phone*

19. Occupation

21. Work Address

23. City

24. State

25. Zip Code

27. Age

28. Race

30. Sex*

    1. Female

    1. Male

32. Contact Information

34. Email*

35. Confirm Email*

37. Incident Information

39. Choose Incident Type*
    -- Select One --Lost PropertyTheft (less than $1,000)Telephone HarrassmentAbandoned VehicleTraffic Complaint (speeding vehicle, etc.)Criminal Damage (less than $1,000)

41. Time Frame in Which Incident Occurred
    Time Frame in Which Incident Occurred Start Date

    Time Frame in Which Incident Occurred Start Time

    —

    Time Frame in Which Incident Occurred End Date

    Time Frame in Which Incident Occurred End Time

43. Information about the Property/Items Involved

45. Dollar Value

46. Incident Location

    (Example: City: Prescott Valley, AZ)

48. Description of Incident

50. Description of lost, damaged or stolen property

52. Confirm Online Police Report
    <ul> <li>I understand that I am filing this report for information / insurance purposes only.</li> <li>I understand that filing this report that there are no known suspects.</li> <li>I understand that there may not be a follow-up investigation conducted by the Prescott Valley Police Department.</li> <li>I understand that filing a false police report is a crime punishable by law.</li> <li>I hereby certify that this report is true and correct to the best of my knowledge.</li> </ul>

    • I understand that I am filing this report for information / insurance purposes only.
    • I understand that filing this report that there are no known suspects.
    • I understand that there may not be a follow-up investigation conducted by the Prescott Valley Police Department.
    • I understand that filing a false police report is a crime punishable by law.
    • I hereby certify that this report is true and correct to the best of my knowledge.

54. I agree to the above terms and conditions.*

    1. I agree

56. Signature

    First Name, Middle Initial, Last Name

57. Current Date
    Current Date

Leave This Blank:


59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit

* indicates a required field