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Hazlet Township Police Department

Damaged Vehicle/Property Form

Vehicle Damage Defined: Keying, broken windows, or attempts to remove parts. This does not include damage as a result of a vehicle being struck by another vehicle.

Is this Report for an Individual or Business

Phone Number

Date of Birth

Driver License Number

Driver License State

Business Name

Business Point Of Contact (POC)

Business POC Phone Number

Extension:

Where Did the Incident Occur

Date when Incident Occurred:

Between: *

And: *

Time frame when Incident Occurred:

Between: *

And: *

Is there any damaged property you need to enter?

Vehicle Information

License plate number

Make and Model

Color and Year

Describe Damage

Item 1

Item 1 - Type

If "other" add item here:

Item 1- Brand

Item 1- Model

Item 1- Color

Item 1- Serial #

Item 1- Quantity

Item 1- Value of Item

Do you need to add another item?

Yes

Item 2

Item 2 - Type

If "other" add item here:

Item 2- Brand

Item 2- Model

Item 2- Color

Item 2- Serial #

Item 2- Quantitiy

Item 2- Value of Item

Narrative

Please enter in a narrative to describe the incident

Please upload any video of incident

Click Here to Upload

I certify this report to be truthful with all accurate information to the best of my knowledge.

First Name

Last Name

Choose how to sign

Draw Type

By checking this box, I understand filing a false police report is a crime. Any person who gives or causes to be given false information to any law enforcement officer, with respect to the commission of any crime or incident, is guilty of a fourth degree crime under the New Jersey Code of Criminal Justice (2C:28-4). Fourth degree crimes are punishable by a fine of not more than $ 1,000.00, or by imprisonment for not more than 18 months, or both.

Receipt

You will be provided with a Receipt upon submission.