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2. Contact Information

4. Agency
6. ORI
8. Officer
10. OCA
12. Date
    Date
14. Type

    1. Entry
    2. Clearance
    3. Modification

16. Reporting Party Information

18. Name
20. Address
22. City
23. State
24. Zip Code
26. Phone

28. Entry Information

30. Stolen Vehicle/License Plate

32. Stolen:

    1. Vehicle
    2. License Plate
33. Date of Theft
    Date of Theft
35. Make
36. Year
38. Model
39. Color
41. VIN

43. Stolen Gun

45. Serial
46. Date of Theft
    Date of Theft
48. Type
49. Model
50. Calliber

52. Stolen Article

54. Serial/OAN
55. Date of Theft
    Date of Theft
57. Type
59. Brand

61. Wanted/Missing Person

63. Date
    Date
65. Name
66. Date of Birth
    Date of Birth
68. Race
69. Height
70. Weight
71. Sex
73. License
74. State
76. Skin Tone
77. SSN
79. Offense
81. Extradition

    1. Full
    2. Limited
    3. None

83. Stolen Boat

85. Date of Theft
    Date of Theft
86. Make
87. Year
89. License
90. State
92. Hull Number
93. Color
94. Length
96. Miscellaneous Information
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98. 1. Receive an email copy of this form.
99. Email address

    This field is not part of the form submission.

100. Submit

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