HTML Preview Security Incident page number 1.
General Offense Number
Security Incident Report
Investigator Use Only:
Refer to Law Department (LD)
Page 1 of____
Date Reported Time Reported Date Occurred (Month, Day, Year) Time Occurred (24hr.)
Incident Location/Address
Offense #1 (Primary) (Check one as applicable) Offense #2
Theft (Shoplift)
Other_____________________________________________
Criminal Trespass
Theft (Shoplift)
Other_____________________________________________
Criminal Trespass
Suspect #1
HT
WT
Hair
Eyes
Suspect Name (Last, First, Middle) Sex
Male
Female
Race
White Black
Asian Indian
Unknown
DOB:
/ /
Mailing Address (Include apartment numbers) City/State Zip Code Phone Home Work
Occupation Employer/School Military Branch
Army Navy AirForce Marine
CO:
Type of Identifications Provided:
No I.D. Verbal Only Other (Clarify in narrative)
Drivers License #___________________________________State:_______ State ID Card #__________________________
Social Security #____________________________________
No I.D. Identified by Police-Officers Names:
Resident? Yes No Statement? Yes No
Clarify suspect release disposition and police response information in the report narrative: Juvenile Suspect Adult Suspect
Released to Parent/Guardian (Name):________________________________________________________________________________
Released to Police (Officer’s Name): _________________________________________________________________________________
Released by Security Police Responded Police Assisted Only
Suspect #2
HT
WT
Hair
Eyes
Suspect Name (Last, First, Middle) Sex
Male
Female
Race
White Black
Asian Indian
Unknown
DOB:
/ /
Mailing Address (Include apartment numbers) City/State Zip Code Phone Home Work
Occupation Employer/School Military Branch
Army Navy AirForce Marine
CO:
Type of Identifications Provided:
No I.D. Verbal Only Other (Clarify in narrative)
Drivers License #___________________________________State:_______ State ID Card #__________________________
Social Security #____________________________________
No I.D. Identified by Police-Officers Names:
Resident? Yes No Statement? Yes No
Clarify suspect release disposition and police response information in the report narrative: Juvenile Suspect Adult Suspect
Released to Parent/Guardian (Name):________________________________________________________________________________
Released to Police (Officer’s Name): _________________________________________________________________________________
Released by Security Police Responded Police Assisted Only
Additional Suspects (Document additional suspects on a second SIR form. Print or Type the assigned police offense number and attach together.)
Victim/Witness
Store Name Address
Institution Type
76 Clothing Store 80 Electronics Store 87 Music/Movie/Game Store
78 Department Store 82 Grocery Store 90 Sporting Goods Store
79 Drug Store 84 Hardware/Home Improvement 89 Other
Phone
Mail entire report to: Seattle Police Department, Data Distribution Section PO Box 34986 Seattle, WA 98124-4986 Within 48 hours of Incident.