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Witness / Victim Statement

  1. I understand I must speak with an officer prior to completing this statement.*
  2. I understand I must have this form signed in front of an officer.*
  3. As provided by an officer.
  4. MM/DD/YYYY
  5. (xxx) xxx-xxxx
  6. Include date, location, and time of occurrence. Identify people with as much information as possible (date of birth, race, gender, phone #, etc.)
  7. Leave This Blank:

  8. This field is not part of the form submission.