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Hazlet Township Police Department

Vehicle Burglary Report

Defined: Unauthorized person enters vehicle and/or property is stolen from inside a motor vehicle

Example: Stolen equipment (radio, speakers, seats etc) or belongings from a vehicle. Vehicle entered, but no items taken.

Today's Date

Date of Birth:

Driver License number

Driver License State

Phone Number

Did incident happen at your home address?

Yes

Date when Incident Occurred:

Between: *

And: *

Time frame when Incident Occurred:

Between: *

And: *

Vehicle License Plate Number

Was Vehicle Unlocked?

Yes

Was force used for entry?

Yes

Describe force used:

Vehicle Make and Model

Vehicle Year

Vehicle Color

Are you the Registered Owner?

Yes

Were items stolen from vehicle?

Yes

Please list missing items and value

Describe incident in detail

Do you have images or video relevant to incident?

Yes

Please upload relevant files

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.

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Hazlet Township Police Department

Vehicle Burglary Report

Today's Date

Full Name

Full Home Address

Did incident happen at your home address?

Address where incident took place

Date when Incident Occurred:

Time frame when Incident Occurred:

Was Vehicle Unlocked?

Was force used for entry?

Are you the Registered Owner?

Name of Vehicle Owner

Address of Vehicle Owner

Were items stolen from vehicle?

Do you have images or video relevant to incident?

Please upload relevant files

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

Receipt