ÐÔÓûÉç

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Type of incident

When did the incident occur? Please list date and time if possible.

Where did it occur?

Did you actually witness the incident?

Please describe the event with as much detail as possible.

Please list the names of all involved. If you do not know the names, provide as much of a description as possible of people and vehicles involved.

If you are willing to have a ÐÔÓûÉç Police Officer contact you, provide your information below.Include name, phone number, and email address.

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