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Suspicious Activity Report

The purpose of the below form is to gather information on suspicious activity that may be related to terrorism. It is important that you provide detailed information on the suspicious activity you have witnessed (i.e. photography, material acquisition /storage, recruiting, eliciting information, etc…) so the incident can be thoroughly investigated. Important details would include: date of the activity, location of the activity, physical identifiers of the actor(s), and a description of vehicle(s) involved.


Incident Title:

Type:
Weapon(s):
Specific Suspicious Behaviors:


Date of Incident:        Submitter Name:        Submitter phone number:
         
Time of Incident:       Submitter Email:         
        
Location of Incident:


Subject(s):
Name:       Sex: Race: Age:   Scars,Marks,Tattoos:   Clothing:
1.
2.
3.

Vehicle(s):
Tag:         State:   VIN:   Make:   Model:   Color:
1.
2.
3.

Incident Summary:


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Upload a PDF or JPEG document: