Incident Report Form

Incident Report

For use when reporting incidents. An incident report must be filled for all suspicious activity, criminal activity suspected or committed, any police visits, any fire department visits, any medical issues, any physical contact or altercations, any arrests made. For any equipment deployments or physical contacts a separate use of force must be filed alongside the incident report.
Incident report issued by:*

First NameMiddle NameLast NameLast 4 of SSN
Report submission date and time:*

MonthDayYearHourMinutesAM/PM Option
Date and Approximate time of incident: *

MonthDayYearHourMinutesAM/PM Option
Incident Location (Please provide specific details such as client, address, and approximate location.)*
Nature of incident: (please explain in detail in the IR Narrative box)*

TrespassingVandalismCriminal Activity SuspectedDeadly Weapon / ForceMedical (Not Employee)Medical (Employee)Suspicious ActivityEmployee Used Of ForceTraffic CollisonOfficial Police ActivityArrest was made ((Non employee)Arrest was made (by employee)Safety ConcernOfficial Media VisitOfficial Agency Visit (Code enforcement, DOT, Investigator, etc)Other - If other briefly summarize below.
Nature of incident - Other explanation
Names of all employees present*
Names of all witnesses present (include contact information if known)*
Persons of Interest (POI)

For persons of interest, list anyone who may be important to the IR.

List what type of interest they may hold. Examples may be Victim, Suspect, Driver, Witness, ETC.

Provide as much physical description information as possible in the description box. Examples: Height, Weight, Sex, Hair, Tatoos, Clothing, ETC

Actions taken by the POIs should be detailed in the IR Narrative.
Persons of Interest 1:

First NameMiddle NameLast NamePOI TYPE
POI 1: POI physical description
Persons of Interest 2:

First NameMiddle NameLast NamePOI TYPE
POI 2: POI physical description
Persons of Interest 3:

First NameMiddle NameLast NamePOI TYPE
POI 3: POI Physical description
List all vehicles of interest (provide details in IR narrative)
What motivated the incident?
Has anyone been arrested so far in relation to the incident? If yes, please list all names and descriptions below.
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Do you want the police to get in touch with you?

YesNo
Was a supervisor notified? if yes, include who in the IR Narrative*

YesNoOther
Was the client notified? if yes, include who in the IR Narrative*

YesNoOther
Further Comments
Incident Report Narrative - Please include as much detail as possible.
Does a copy of this report need to be forwarded to anyone. If yes, please provide the requesting organizations information and contact information of the person requesting agency below. DO NOT PROVIDE IR details to outside entities without management approval. *
Do videos or photos of incident exist?*

YesNoOther
If yes, please detail where. Include any social media links. Make an attempt to screen shot in case of future deletion.
FILE UPLOAD, document or photo

Upload a File

Cancelof
Photos or Videos relating to the incident

Please email all relevant photos or videos to swtreports@outlook.com. Make sure to include IR number below or date and location in the subject.
SUBMISSION NUMBER
Should be Empty: