Your Name
Address
City, State and Zip
Phone Number(s)
Email Address
** Please provide as much information below as possible. **
Address of suspected drug activity
City, State and Zip
Describe the house and property including color, location on the block, single multiple stories, etc.
Type in information:
Do you know the names of the occupants of the suspected drug house?
If yes, please provide:
Description of the occupants (gender, race, approximate age, height, weight, scars, tattoos, etc.)
Type in information:
Are there any children in the residence?
If yes, how many?
What are their approximate ages?
Have the occupants of the suspected drug house taken measures to reinforce the residence (bars on windows, video surveilance, etc.?
Please select yes or no.
If yes, please explain:
Do you know or suspect the type of drugs that are being sold?
Do you know the residents to own or carry weapons?
Please describe the vehicles used by the occupants of the suspected drug house, include the plate number, state, year, make, model and color.
Type in information:
Do you know or suspect the type of drugs that are being sold?
If yes, please indicate the type of drug(s):
Have you witnessed apparent drug transactions near this residence?
Please document any pattern of unusual activity at this location, such as specific time of day/night when foot or vehicle traffic is greatest.
Type in in information:
How long has the suspected drug activity been occurring?
Do you know if the suspected drug house is a rental property?
If yes, please list the owner name and contact information:
Further Information:
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Email Address:
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