Non-Emergency Traffic Complaint Report

Non-Emergency Traffic Complaint Report
Basic Information
Days Problem Occurs*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Time(s) Problem most often occurs*

12 A.M. to 3 A.M.3 A.M. to 6 A.M.6 A.M. to 9 A.M.9 A.M. to 12 P.M.12 P.M. to 3 P.M.3 P.M. to 6 P.M.6 P.M. to 9 P.M.9 P.M. to 12 A.M.
Type of Complaint*

SpeedingReckless DrivingTraffic Control DevicePassing Stopped School BusOther
Is this a recurring Problem*

YesNoI don't know
If this problem is recurring problem, how frequently is it occurring? How Often
Location of Problem*
Vehicle Information
Vehicle Make
Vehicle Model
Vehicle Year (Approximate)
Vehicle Color
License Plate Number
License Plate State
Vehicle Operator Information
Gender of Vehicle Operator

MaleFemaleUnknown
Race of Vehicle Operator

WhiteBlackHispanicAsianUnknown
Height of Vehicle Operator
Weight of Vehicle Operator
Hair Color of Vehicle Operator
Clothing Description of Vehicle Operator (if Known)
Please describe the problem you are having.
You may elect to not provide your identity to us. If you do provide your identity to us, it will not be released to anyone outside the Long County Sheriff's Office.
Complainant Name

First NameLast Name
Complainant Email
example@example.com
Complainant Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Complainant Phone Number
Please enter a valid phone number.
Please verify that you are human*
Do you want to receive an email copy of this form

Yes, I want to receive a copy of this form emailed to me.
Your Email Address
example@example.com
Should be Empty:

Non-Emergency Traffic Complaint Report

Basic Information

Vehicle Information

Vehicle Operator Information