Broken Arrow Police Department

Citizen's Crime Report



Citizen's Crime Reports must be assigned a case number to be recognized as an official police report.
Who is the victim    
If you picked Business, fill out the information below.  If you picked Me, proceed to Your Personal Information.              Please fill out form as completely as possible.
Business Information    
Business Name Business Address Business Phone
     
Your Personal Information
Last name  (Required field) First name   (Required field) Middle name
     
Address  (Required field) City State Zip
       
Day Phone  (Required field) Evening Phone Date of Birth  (Required field) SSN
       
Drivers License #   Email Address  (Required field)
     
Location Where Crime Occurred
Address City State Zip
       
This Crime Occurred Between  
IF YOU DON'T KNOW EXACTLY WHEN THE CRIME HAPPENED:
(FOR EXAMPLE: You go to sleep at 11:00 PM on Friday night. You wake up Saturday morning at 8:00 AM and find out you are the victim of a crime. The crime happened BETWEEN Friday at 11:00 PM AND Saturday at 8:00 AM)
Start Date Start Time 

and

End Date End TIme
         
My vehicle was involved in the crime
Vehicle year Vehicle Make Vehicle Model Tag number Color
         
List property that was lost, stolen or damaged
Item # Description / Serial Number Value Estimate Lost/Stolen/Damaged
1    
2    
3    
4    
5    
6    
7    
8    
9    
10    
 
List Witnesses
Name Address Phone number
     
     
     
Suspects

1

Name Address Race Sex Height Weight
       
Phone Number Clothing Hair Eyes Age
     

2

Name Address Race Sex Height Weight
       
Phone Number Clothing Hair Eyes Age
     
Suspect Vehicle
Year Make Model Tag Number Color
           
Narrative
EXAMPLE: I woke up at 8:00 AM and found my car had been broken into. They broke my left
front window with a rock to get in. They stole my stereo and tapes. My neighbor saw two men
in my car at 7:00AM
 

I AM THE VICTIM OR A REPRESENTATIVE OF THE VICTIM OF THIS CRIME. THE INFORMATION IN THIS REPORT IS TRUE. I WILL ASSIST IN THE PROSECUTION OF THOSE PERSONS RESPONSIBLE FOR THIS CRIME.

WARNING: IT IS A VIOLATION OF BOTH CITY AND
STATE CRIMINAL CODES TO WILLFULLY MAKE A FALSE POLICE REPORT

Use the reset button to start over....when the report is completed click on the submit button one time. If you receive an error message after submitting your report please do not resubmit the report. Forward all details regarding the error to Crimereporthelp@brokenarrowok.gov

  Please make sure you PRINT this form before submitting.

  Clicking here will clear entered data so you my begin again.