Lost / Stolen State Key(s) or Hangtags

Lost / Stolen State Key(s) or Hangtags

University Police
Item lost*
The item is*
Building Name*
Building Room*
Vehicle Make*
Vehicle Model*
Vehicle Plate #*
Assigned Hangtag #
Optional. Enter if known.
Location of Occurrence*
Date and Time of Occurrence*

MonthDayYear
Date
Hour MinutesAM/PM Option
Provide Additional Information
Complainant Information
Name*

First NameMiddle NameLast Name
Employee ID*
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
I have completed and read (or had read to me) the above statement and it is true to the best of my knowledge. I fully understand that if I make a statement which is untrue and which is intended to mislead a law enforcement official in the performance of their official function, I will be in violation of Section 53a-157 of the Connecticut General Statutes. A false statement is a Class - A Misdemeanor.
Signature*

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