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2. If reckless driving or racing is occurring now - call 911.  
   
   

   Injury accidents should be reported by calling 911. 
   Do not use this form to report any traffic accident with injuries.
   
   

   If you or someone else is in immediate danger, please call 911 or your local police.  

4. Name of Reporting Person*
6. Address*
8. City*
9. State*
10. Zip Code*
12. Home Phone*
13. Email*
15. Traffic Incident/ Issue Details
17. Location of Incident/Issue*
19. Date/Time in Which Incident Occurred*
    Date/Time in Which Incident Occurred

    Date/Time in Which Incident Occurred
21. Speeding and Want Extra Enforcement*

    1. Yes
    2. No
23. Hit & Run on Private Property*

    1. Yes
    2. No
25. Traffic Accident WITHOUT injuries on Public Property*

    1. Yes
    2. No
27. Traffic Accident on Private Property WITHOUT injuries, or a Hit & Run, or a suspected DUI*

    1. Yes
    2. No

    ***If "Yes," Prescott Valley Police Department has no jurisdiction. Do not submit this form.****

29. Additional Information about the Incident or Issue
31. A traffic accident with injuries should be reported by calling 911. Do not submit 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 Police, you will be provided with a report number.

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33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field