Drug Activity Complaint
Drug Activity Complaint Form
Please provide the following contact information:
Note: All complainant information is kept confidential. Please read the
introduction
prior to use.
First Name
Last Name
Street Address
Address (cont.)
City
Zip Code
Work Phone
Home Phone
Cell Phone
Email
Note: Please provide as much information below as possible
Address of suspected activity:
Street Address
Address (cont.)
City
Zip Code
Activity Location
Select One
Alley or Driveway
Garage
Inside Business
Inside Private Residence
Park
Street Corner
Vacant Lot
Phone Number
Pager Number
Description of person that resides at suspect address:
First Name
Last Name
Age
Sex
Male
Female
Race
Select Race
Asian
Black
Hispanic
Other
White
Height
Weight
Hair Color
Select Hair Color
Unknown
Blonde
Brown
Black
Red
Gray
White
Eye Color
Select Eye Color
Unknown
Blue
Brown
Black
Green
Gray
Violet
Other person that resides at suspect address:
First Name
Last Name
Age
Sex
Male
Female
Race
Select Race
Asian
Black
Hispanic
Other
White
Height
Weight
Hair Color
Select Hair Color
Unknown
Blonde
Brown
Black
Red
Gray
White
Eye Color
Select Eye Color
Unknown
Blue
Brown
Black
Green
Gray
Violet
Other person that resides at suspect address:
First Name
Last Name
Age
Sex
Male
Female
Race
Select Race
Asian
Black
Hispanic
Other
White
Height
Weight
Hair Color
Select Hair Color
Unknown
Blonde
Brown
Black
Red
Gray
White
Eye Color
Select Eye Color
Unknown
Blue
Brown
Black
Green
Gray
Violet
Other person that resides at suspect address:
First Name
Last Name
Age
Sex
Male
Female
Race
Select Race
Asian
Black
Hispanic
Other
White
Height
Weight
Hair Color
Select Hair Color
Unknown
Blonde
Brown
Black
Red
Gray
White
Eye Color
Select Eye Color
Unknown
Blue
Brown
Black
Green
Gray
Violet
Type of Drug (if known):
Cocaine
Heroin
Marijuana
Methamphetamine
Other
Vehicles
Suspect Vehicle
(year/make/model/color)
Vehicle License Plate (include state)
Other vehicle at Site
(year/make/model/color)
Vehicle License Plate (include state)
Other vehicle at Site
(year/make/model/color)
Vehicle License Plate (include state)
Other General Information
How long has the suspected activity been occurring?
Please describe type of activity occurring and how you know the activity is occurring
(personally observed, heard about, etc.):
Are there children residing at the suspected address
Yes
No
Have you observed other suspicious activity such as the following:
Look outs
Surveillance Cameras
Weapons
Other
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