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2. 
4. Request for Incident Report
   Please provide as much information as possible to include the case number (OCA) that was given to you by the deputy on scene at the time of the incident. Insufficient information may result in the inability to locate your report.
6. Your First Name*
7. Your Last Name*
9. Your Phone Number*
10. Cell Phone Number
11. Your Email Address
13. Location of Incident*
15. City*
16. State*
17. Zip*
19. Date and Time of Incident
    Date and Time of Incident

    Date and Time of Incident
21. Victim Information
23. First Name of Victim
24. Middle Name of Victim
25. Last Name of Victim
27. Offender Information
29. Name of Offender
30. Last Name of Offender
32. Incident (OCA) Number
    Note: This number is located on the case states sheet provided by the deputy on scene at the time of the incident.
34. Signature*
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36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit Submit and Print

* indicates a required field