Self-Initiated Incident Report Form
PURPOSE: This form is used to report incidents that occur within the City of
Janesville to the Janesville Police Department. Report content will be
considered for either future investigation or maintained as a Department record. Self-initiated Incident Reports that are deemed inappropriate, lack jurisdiction, or are otherwise not within the scope of police responsibility will be returned to the sender.
INSTRUCTIONS: Complete all applicable portions of this form. Use full name(s) if known. Describe property with all available identifiers including serial numbers, if known. Explain the circumstances with details, including date, time and location. Incomplete information will delay report processing. You may deliver this report to the Janesville Police Department by e-mail, FAX, or in person.
Getting Started
In order to be able to use this form to report an incident, the incident must have occurred in the City of Janesville and you must also be able to answer "No" to the following questions. If the incident did not occur in the City of Janesville you must contact the law enforcement agency with jurisdiction where the incident occurred.
General
Contact Information
*Required. If you don’t have an email address, you may print the report to submit by mail, FAX or in person.
Persons
* In order to add a person, please fill out the person information and
click the "Add". More than one person can be added to
the form.
Business
Vehicles
* In order to add a vehicle, please fill out the vehicle information and
click the "Add". More than one vehicle can be added to
the form.
Property
* In order to add a property, please fill out the property information and
click the "Add". More than one property can be added to
the form.
Upload Pictures
If you like submit some pictures, please add your file(s) to the following list(.jpg file only, upto five files and less then 2 MB for each.).
Please briefly describe this incident:
The preceding information is provided to the Janesville Police Department for whatever purposes the police department deems necessary. I certify the information contained herein is true and correct to the best of my ability.