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Incident Types
Reporting Persons
Involved Contacts
Incident
Vehicles Involved
Property
Digital Media
Review Report
Finish Report
Requestor's IP Address : 18.217.146.61
Select Report Type
Please select the report type:
Original or Supplemental.
Select
Report Type
Definition
Original
This is the first report you have filed for this incident.
Supplemental
You are adding information to a
previous report
which was
submitted online
.
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Original Online Report Number:
Select Incident Type(s)
Select
Incident Type
Definition
Examples
Lost Item Report
This report is utilized to report items that are believed to be missing and last seen at a Town of Perinton property.
Lost wallet, phone, personal items, etc.
Select Reporting Person Type
Please select a proper person type according to the definition below.
Select
Person Type
Definition
Individual
If you are reporting this for yourself.
Business
If you are responsible for reporting this for your employer or your own business.
Enter Reporting Person Information
Please enter your information as completely as possible. You may be contacted regarding this incident. An email address is required if you would like to be notified when this report is received and approved.
Person Type:
ALARM COMPANY
APPLICANT
CONTACT PERSON
CONTRACTOR
DRIVER
EMERGENCY CONTACT
EMPLOYEE
HUNTING PERMIT
IMPORT
OTHER
PARENT/GUARDIAN
PROPERTY OWNER
REPORTING PERSON
SPOUSE
SUPERVISOR
SUSPECT
VEHICLE OCCUPANT
VEHICLE OPERATOR
VEHICLE OWNER
VICTIM
WITNESS
Employee ID:
First Name:
Middle Name:
Last Name:
Home Address:
City
 /
State
 /
Zip Code:
 /
Country
 ,
 ,
,
Home Phone:
Mobile Phone:
Email Address:
Email report to this address
Confirm Email:
Employer Name:
Work Address:
City
 /
State
 /
Zip Code:
/
Country
 ,
 ,
,
Work Phone:
Race:
ASIAN
BLACK
HISPANIC
N/A
OTHER
WHITE
Sex:
FEMALE
MALE
DOB:
May
2024
Driver License Number:
Licensing State:
Person Type
Name
Home Phone
Mobile Phone
Work Phone
Enter Involved Contact Information
Please enter your information as completely as possible. You may be contacted regarding this incident. An email address is required if you would like to be notified when this report is received and approved.
Person Type:
ALARM COMPANY
APPLICANT
CONTACT PERSON
CONTRACTOR
DRIVER
EMERGENCY CONTACT
EMPLOYEE
HUNTING PERMIT
IMPORT
OTHER
PARENT/GUARDIAN
PROPERTY OWNER
REPORTING PERSON
SPOUSE
SUPERVISOR
SUSPECT
VEHICLE OCCUPANT
VEHICLE OPERATOR
VEHICLE OWNER
VICTIM
WITNESS
Employee ID:
First Name:
Middle Name:
Last Name:
Home Address:
City
 /
State
 /
Zip Code:
/
Country
 ,
 ,
,
Home Phone:
Mobile Phone:
Email Address:
  
Email report to this address
Confirm Email:
Race:
ASIAN
BLACK
HISPANIC
N/A
OTHER
WHITE
Sex:
FEMALE
MALE
DOB:
Driver License Number:
Licensing State:
Person Type
Name
Home Phone
Mobile Phone
Work Phone
Enter Incident Information
Please enter all the information that applies. If you do not know the address of the incident, use the nearest intersection such as Market St./ 10th St. Please ignore previous instructions. LB
Street Address:
City
 /
State
 /
Zip Code:
/
Country
 ,
 ,
,
Incident Time (start):
Incident Time (end):
Have Vehicle Info to Enter?:
Yes
No
Have Property Info to Enter?:
Yes
No
Have Digital Media to Enter?:
Yes
No
Origin of Threat:
Incident Description:
(Characters Left)
Enter Vehicle Information
Please enter the Vehicle information.
Type:
2 DOOR VEHICLE
4 DOOR VEHICLE
BOAT
CONSTRUCTION EQUIPMENT
DUMP TRUCK
PICKUP
SCHOOL BUS
TRAILER
TRUCK
Make:
ACURA
AUDI
BLUE BIRD
BMW
BUICK
CADILLAC
CASE
CATERPILLAR
CHEVROLET
CHRYSLER
DODGE
FIAT
FORD
GMC
HARLEY DAVIDSON
HONDA
HUMMER
HYUNDAI
INFINITI
INTERNATIONAL
ISUZU
JAGUAR
JEEP
KAWASAKI
KENWORTH
KIA
LEXUS
LINCOLN
MAZDA
MERCEDES BENZ
MITSUBISHI
NEW HOLLAND
NISSAN
OLDSMOBILE
OTHER
PLYMOUTH
PONTIAC
PORSCHE
RANGE ROVER
SAAB
SATURN
SCION
STERLING
SUBARU
SUZUKI
TESLA
TOYOTA
TRIUMPH
VOLKSWAGEN
VOLVO
WESTERN STAR
WORKHORSE
YAMAHA
Model:
Year (YYYY) :
Color:
BLACK
BLUE
GREEN
GREY
OTHER
PURPLE
RED
SILVER
TAN
WHITE
YELLOW
License Plate Type:
AUTOMOBILE
BOAT
FARM VEHICLE
GOVERNMENT
MOTORCYCLE
PASSENGER
SEMI-TRUCK
TRAILER
TRUCK
License Plate Number:
(do not enter spaces)
Licensing State:
VIN:
(do not enter spaces)
Insurance Company Name:
Insurance Policy #:
Insurance Policy Expiration Date:
Enter Property Information
Please enter the Property information.
OwnerShip:
COMPANY
PERSONAL
Type:
ATHLETIC EQUIPMENT
BAG/BOOKBAG/LUGGAGE
BICYCLE
BLANKET
BOOK
CELL PHONE
CLOTHING
CUP/GLASS/BOTTLE
DRUGS/PARAPHERNALIA
ELECTRONIC EQUIPMENT
FURNITURE
GLASSES
GLOVES
IDENTIFICATION/DOCUMENT
IPOD/MP3
JEWELRY
KEYS
LAPTOP
LOCK-COMBINATION/PADLOCK
MONEY
OTHER
OTHER VALUABLE
PURSE/WALLET
SCOOTER
SIGN/POSTER
STRUCTURES
TOY
WATCH
WEAPON
Subtype:
Brand:
Model:
Color:
BLACK
BLUE
BROWN
CLEAR
GOLD
GREEN
GREY
MULTI COLOR
ORANGE
OTHER
PINK
PURPLE
RED
TAN
WHITE
YELLOW
Serial Number:
How Many:
Approx. Market Value ($):
Property Description:
Select Digital Media
Please select any digital media (pictures, documents or any digital data files) up to 2047 MB that are relevant to this incident.
File Name
Title
Description
Review Report
Please review the report. If all the information is correct, click the Continue button to submit the report. If you need to modify some information, click the desired modify link. This will be your last chance to change information for this report.
General Information:
Incident Type(s):
Reporting Person/Involved Contact Information:
Incident Information:
Incident Location:
Incident Time (start):
Incident Time (end):
Origin of Threat:
Incident Description:
Vehicle Information:
Type:
Make:
Model:
Year (YYYY):
Color:
License Plate Type:
License Plate Number:
Licensing State:
VIN:
Insurance Company Name:
Insurance Policy #:
Insurance Policy Expiration Date:
Property Information:
OwnerShip:
Type:
Subtype:
Brand:
Model:
Color:
Serial Number:
How Many:
Market Value($):
Property Description:
Digital Media:
Your report has been submitted.
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