1. Where is the problem activity ?

House No.
Street
City/Town

2. What type of location is this?

Inside Business
Inside Private Residence
Alley or Driveway
Hallway/Corridor
Park/Wooded Area
Sidewalk/Street Corner
Vacant Lot
Vehicle
Garage

Other, Please describe

3. Please describe the activity.

4. When does the activity usually occur?

Morning
Afternoon
Evening
Overnight

5. Do you know specific days or times the activity usually occurs?

6. Please tell us about the individual involved.

Name
Nickname
Age
Race / Sex
Phone Number
Address
Physical Description (height, weight,  hair color etc.)
Gang Member	Yes No Unknown
Which Gang

7. Please tell us about  the vehicle this person uses.

Make
Model
Year
Color
Plate Number
Unique Features

8. Is there any other information you believe would be helpful to Yakima County Sheriff's Office?

9. If you want a member of the Yakima County Sheriff's Office to contact you please include your contact information on the lines below.  This information is purely voluntary.

Name
Address
Work Phone
Home Phone
E-mail

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