Victim Type

Is the victim of the crime that you are reporting a person or a business?

Business

Person

Victim's Name

Victim's Address

Victim's Phone Number

Your Information

Name*

Date of Birth*

Address*

City*

State*

Zip*

Home Phone Number*

Cell Phone Number

Email Address

Incident Information

Incident Type*

Lost Property Damage to Property Vandalism Report Theft from Vehicle

Date and Time of Incident*

Estimated Dollar Value of Damages / Loss*

Incident Location

Description of Property*

Please be concise. Describe property lost, taken, or damaged.

Description of Incident*

Please be concise.

Confirm Online Police Report

• I understand that I am filing this report for information / insurance purposes only.
• I understand that filing this report shows that there are no known suspects.
• I understand that no follow-up investigation will be conducted by the Valparaiso Police Department.
• I understand that filing a false police report is a crime punishable by law.
• I hereby certify that this report is true and correct to the best of my knowledge.

*

I agree to the above terms and conditions

Electronic Signature*

First name, middle initial, last name