2. If this is an Emergency - call 911
4. Does this crime involve a Traffic accident or issue?*

   1. Yes
   2. No

   if "Yes" - Please click here to Report a Traffic Incident or Issue. Do Not Use This Form.

6. PLEASE READ

   STOP - DO NOT USE THIS FORM. 

   
   

   You selected "Yes" when answering "Does this crime involve a Traffic accident or issue?". 

   Do not use this form to report a Traffic accident or issue.

   
   

   Please click here to Report a Traffic Incident or Issue.

8. Adult Protective Services is required to call (928) 772-9267 or 911 if an Emergency. (Do Not Use This Form)
10. Type of Crime*
    -- Select One --Lost PropertyTheftCriminal DamageFraudOther
12. If "Other" please describe
14. Is there evidence of the crime that the police need (i.e. photos) or was the crime captured on surveillance video (yours or a neighbor's)?*

    1. Yes
    2. No
16. Are you reporting a lost or stolen firearm?*

    1. Yes
    2. No
18. Do you have any suspect leads (description, license plate number, name of suspect)?*

    1. Yes
    2. No
20. Was there any injury to anyone?*

    1. Yes
    2. No
22. Was a weapon used or threatened to be used?*

    1. Yes
    2. No
24. Are you under 18 years of age?*

    1. Yes
    2. No
26. Are you reporting a stolen vehicle?*

    1. Yes
    2. No
28. Was your car or home broken into?*

    1. Yes
    2. No
30. Misdemeanor crimes: Did the crime occur more than a year ago?*

    1. Yes
    2. No
32. Did the crime occur outside of Prescott Valley Town limits?*

    1. Yes
    2. No

    Click here to check the crime address

34. If you answered "Yes" to any of the above questions or are unsure, and this is NOT AN EMERGENCY call 928-772-9267. If you answered "Yes" to the question about Traffic, please click here to Report a Traffic Incident or Issue.

    13-3620.01. False Reports: A person who knowingly and intentionally makes a false report is committing a crime.

36. If you answered "No" to all the above questions, please answer the following: Do you live in Prescott Valley?*

    1. Yes
    2. No

    Click here to check address

38. Dollar Value
40. Description of Incident
42. Description of lost, damaged or stolen property
44. Reporting Person's Information
46. Name*
47. Date of Birth*
    Date of Birth
49. Address*
51. City*
52. State*
53. Zip Code*
55. Phone*
56. Email*
58. Age
59. Race
61. Sex

    1. Female

    1. Male
63. Confirm Online Police Report
    • I understand that I am filing this report for information / insurance purposes only.
    • I understand that filing this report that there are no known suspects.
    • I understand that there may not be a follow-up investigation conducted by the Prescott Valley Police Department.
    • I understand that filing a false police report is a crime punishable by law.
    • I hereby certify that this report is true and correct to the best of my knowledge.
65. I agree to the above terms and conditions.*

    1. I agree
67. Signature*

    First Name, Middle Initial, Last Name

68. Today's Date*
    Today's Date

70. Please click here to Report a Traffic Incident or Issue. Do Not Use This Form.
    
    

    **You will be contacted on the next working day. The online report you make is not an official report. The Crime Prevention Officer will discuss your case with you. If it is determined that a crime was committed in the jurisdiction of Prescott Valley, you will be provided with a report number.**

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72. 1. Receive an email copy of this form.
73. Email address

    This field is not part of the form submission.

74. Submit

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