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Incident Report Form

THIS FORM SHOULD ONLY BE USED FOR MINOR INCIDENTS.

The information you submit below will become property of Elon Police Department. Persons filing a false police report will be prosecuted. According to North Carolina General Statute 14-225, false reports to law enforcement agencies or officers will be handled as follows: Any person who shall willfully make or cause to be made to a law enforcement agency or officer any false, misleading or unfounded report, for the purpose of interfering with the operation of law enforcement agency, or to hinder or obstruct any law enforcement officer in the performance of his duty, shall be guilty of a class 2 misdemeanor.



Date/Time of Incident: 
/ /    
Location of Incident: 

Name of victim: 
Date of Birth:  / /
Gender:   Race/Ethnicity: 
Address of victim: 
Employer Name/Address: 
Email Address: 
Home Phone: 
Business Phone: 
Property Description Make/Model Serial No. Qty Value
Details of Incident: 
 
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