JPD 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, must be a belated incident, and you must also be able to answer "No" to the other 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.

Is this an emergency?	Yes No
Is anyone injured?	Yes No
Was a weapon used or threatened to be used?	Yes No
Was any level of force used or threatened?	Yes No
Is this a belated incident?	Yes No
Did this happen in the City of Janesville?	Yes No

General

Incident Type

Incident Location*

Occurred Start*

Occurred End*

Contact Information

Your Name*:

E-mail*:

Phone:

May we contact you regarding this report?

The best time to contact you is?

Preferred method of contact?

*Required. If you don’t have an email address, you may print the report to submit by mail, FAX or in person.

Persons

Add Person

There is no person. In order to add a person, please click the "Add Person". More than one person can be added to the form.

Business

Business Name:

Address:

Vehicles

There is no vehicle. In order to add a vehicle, please click the "Add Vehicle". More than one vehicle can be added to the form.

Property

There is no property. In order to add a property, please click the "Add Property". More than one property can be added to the form.

Uploads
If you would like to submit some pictures, reports or property spreadsheets please add your file(s)(.jpg, .jpeg, .doc, .docx, .xls, .xlsx, .pdf file only, up to five files and less than 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.