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2. Online Reporting System Disclaimer

4. Disclaimer*

   Pursuant to Maryland Code, Criminal Law, Title 9 - Crimes Against Public Administration, Subtitle 5 - False Statements, Section 9-501. False statement - To law enforcement officer. (a) Prohibited.- A person may not make, or cause to be made, a statement, report, or complaint that the person knows to be false as a whole or in material part, to a law enforcement officer of the State, of a county, municipal corporation, or other political subdivision of the State, or of the Maryland-National Capital Park and Planning Police with intent to deceive and to cause an investigation or other action to be taken as a result of the statement, report, or complaint. (b) Penalty.- A person who violates this section is guilty of a misdemeanor and on conviction is subject to imprisonment not exceeding 6 months or a fine not exceeding $500 or both. [An Code 1957, art. 27, Section 150(a), (c); 2002, ch. 26, Section 2.]

   1. I Agree
   2. I Do Not Agree
6. Is this an Emergency?*

   1. Yes
   2. No
8. Emergency Response

   This is an emergency and should be reported via 911. You will not be able to submit this incident via the online portal.

10. Did this incident occur in the Town of Cheverly?*

    1. Yes
    2. No
12. Non-Reportable Criteria

    This does not meet the criteria necessary to report via the online portal.

    You will not be able to submit this incident via the online portal.

    Please dial 301-352-1200 in order to report the incident.

14. Are the offenders known?*

    1. Yes
    2. No

    This does not include individuals who you suspect to be involved.

16. Non-Reportable Criteria

    This does not meet the criteria necessary to report via the online portal.

    You will not be able to submit this incident via the online portal.

    Please dial 301-352-1200 in order to report the incident.

18. Were there any witnesses?*

    1. Yes
    2. No

    This does not include yourself, if applicable.

20. Non-Reportable Criteria

    This does not meet the criteria necessary to report via the online portal.

    You will not be able to submit this incident via the online portal.

    Please dial 301-352-1200 in order to report the incident.

22. Has this incident already been reported, to any other LE agency?*

    1. Yes
    2. No
24. Non-Reportable Criteria

    This does not meet the criteria necessary to report via the online portal.

    You will not be able to submit this incident via the online portal.

    Please dial 301-352-1200 in order to report the incident.

26. Is there any evidence present, requiring collection?*

    1. Yes
    2. No
28. Non-Reportable Criteria

    This does not meet the criteria necessary to report via the online portal.

    You will not be able to submit this incident via the online portal.

    Please dial 301-352-1200 in order to report the incident.

30. Does this incident appear to have hate/bias motivation?*

    1. Yes
    2. No

    This would include any incident that appears, or is perceived by the victim, to be motivated all, or in part, by race, color, religious beliefs, national origin, ethnic background, sexual orientation, disability, etc.)

32. Non-Reportable Criteria

    This does not meet the criteria necessary to report via the online portal.

    You will not be able to submit this incident via the online portal.

    Please dial 301-352-1200 in order to report the incident.

34. Did this occur on a state highway?*

    1. Yes
    2. No
36. Non-Reportable Criteria

    This does not meet the criteria necessary to report via the online portal.

    You will not be able to submit this incident via the online portal.

    Please dial 301-352-1200 in order to report the incident.

38. Does this incident involve a vehicle crash?*

    1. Yes
    2. No
40. Non-Reportable Criteria

    This does not meet the criteria necessary to report via the online portal.

    You will not be able to submit this incident via the online portal.

    Please dial 301-352-1200 in order to report the incident.

42. Your Name*
43. Your Email Address*
45. Your Phone Number*
47. Address*
49. Incident Type*
    -- Select One --Auto TamperingDestruction of PropertyHarassmentLost PropertyProperty DamageTheft From AutoTheft: Other
51. Date of Occurrence*

    Please put a range if the exact date is unknown.

52. Time of Occurrence*

    Please put a range if the exact date is unknown.

54. Location of Incident*

    Please provide the address of where the incident occurred.

56. Property Item #1 (If Applicable)

    Please fill out/include all applicable information: Property Description, Quantity/Amount, Color, Total Value, Make, Model, Serial Number/VIN, Condition, Misc. Identifying Marks.

58. Property Item #2 (If Applicable)

    Please fill out/include all applicable information: Property Description, Quantity/Amount, Color, Total Value, Make, Model, Serial Number/VIN, Condition, Misc. Identifying Marks.

60. Property Item #3 (If Applicable)

    Please fill out/include all applicable information: Property Description, Quantity/Amount, Color, Total Value, Make, Model, Serial Number/VIN, Condition, Misc. Identifying Marks.

62. Incident Narrative*

    Please be as detailed as possible in your description of the incident and what occurred.

Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit

* indicates a required field