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Plainview Police Department Report of Incident

  1. (Notice if you have an emergency or a crime is in progress, dial 911.)
  2. Section A: Details of Offense/Incident
  3. Section B: Reporting Person
  4. Were you injured as a result of this offense/incident?
  5. Section C: Involved Persons
  6. Were you injured as a result of this offense/incident?
  7. Description
  8. Tattoos:
  9. Were you injured as a result of this offense/incident?
  10. Description
  11. Tattoos:
  12. Were you injured as a result of this offense/incident?
  13. Description
  14. Tattoos:
  15. Were you injured as a result of this offense/incident?
  16. Description
  17. Tattoos:
  18. If other persons are involved, explain in "Supplemental Information" Section .
  19. Section D: Vehicles/Property
  20. 1
  21. 2
  22. 3
  23. 4
  24. If other vehicles or property are involved, explain in "Supplemental Information" Section.
  25. Include any information and details relevant to this incident and not previously entered.
  26. Leave This Blank:

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