Hate Crime Information
Description of Hate Crime: (Character Limit: 500)
Suspect's Last Known Location:
Victim Information:
Victim Sex Assigned at Birth:
-- Select --
Male
Female
Unknown
Victim Gender Identity:
-- Select --
Male
Female
Transgender Woman / Transfeminine
Transgender Man / Transmasculine
Nonbinary / Gender Nonconforming
Other
Decline to Answer
Unknown
Victim Gender Identity (Other):
Victim Sexual Orientation:
-- Select --
Straight / Heterosexual
Lesbian / Gay
Bisexual
Asexual
Pansexual
Queer
Other
Decline to State
Victim Sexual Orientation (Other):
Victim Religious Affiliation:
-- Select --
Christianity/Roman Catholicism
Judaism
Islam
Hinduism
Buddhism
Sikhism
Other (Please Specify)
Victim Religious Affiliation (Other):
Victim Ethnicity / Race:
-- Select --
Asian
Hispanic
Middle Eastern / North African
Native American
Native Hawaiian / Other Pacific Islander
White
Other / Not Specified Above
Black
Victim Disabled?:
-- Select --
Yes
No
Decline to State
Disability Description:
Incident Date:
Approximate Time: (24 Hour Format)
Address of Crime:
City:
State:
-- Select --
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
County:
Suspect Information
First Name:
Middle Name:
Last Name:
Known Alias(es):
Race:
-- Select --
White
Black
Hispanic
Asian
Mixed
Other
Suspect Sex Assigned at Birth:
-- Select --
Male
Female
Unknown
Suspect Gender Identity:
-- Select --
Male
Female
Transgender Woman / Transfeminine
Transgender Man / Transmasculine
Nonbinary / Gender Nonconforming
Other
Decline to Answer
Unknown
Suspect Gender Identity (Other):
Height Feet:
-- Select --
1
2
3
4
5
6
7
8
Height Inches:
-- Select --
0
1
2
3
4
5
6
7
8
9
10
11
Date of Birth:
Age:
Weight (Lbs):
Eye Color:
-- Select --
Black
Blue
Brown
Grey
Green
Hazel
Maroon
Pink
Multicolored
Other
Hair Color:
-- Select --
Black
Blue
Blonde / Strawberry
Brown
Green
Grey
Multicolored
Orange
Pink
Purple
Partially or Completely Bald
Red / Auburn
Sandy
Other
Hair Description:
Suspect's Home Information
Street Address:
Address: (continued)
City:
State:
-- Select --
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
Additional Suspect Information
Social Media Usernames:
Unique Attributes:
Gang Affiliation:
Additional Suspect Information:
Suspect's Clothing Description:
Suspect Employer:
Vehicle Information
Make:
Model:
Color:
Plate #:
Plate State:
-- Select --
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Notes:
Tipster Information
(Leave Blank to Remain Anonymous)
Name:
Telephone Number:
E-mail Address: