File a Report - Crime | City of Bartlesville

Where there other identifiable individuals involved?*

Yes
No

1st Individual Involved*

1st Individual Info

Name

First Middle Last

Date of birth

Marital Status

Race

Sex

Hair Color

Eye Color

Hispanic

Yes
No

Height

Weight

Change to Native American? If yes what tribe and roll number:

Home Phone

Cell Phone

Employment Address

Street Address Address Line 2 City State ZIP Code

Work Phone

2nd Individual

Was there a second identifiable individual?*

Yes
No

2nd Individual Info

2nd Individual Involved*

Individual
Victim
Witness
Suspect

Name

First Middle Last

Date of birth

Race

Sex

Hair Color

Eye Color

Hispanic

Yes
No

Height

Weight

Change to Native American? If yes what tribe and roll number:

Home Address

Street Address Address Line 2 City State ZIP Code

Home Phone

Cell Phone

Employment Address

Street Address Address Line 2 City State ZIP Code

Work Phone

Description	Serial Number	Value	Lost/Stolen/Damaged

File a Report – Crime

Step 1 of 7

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List Your Reporting Party Information

1st Individual Info

2nd Individual

2nd Individual Info

Vehicle Info

When and where did this crime occur?

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