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2. 
3. Sheriff Parnell McNamara | McLennan County

   901 Washington Avenue | Waco, Texas 76701 | 254-757-5095 | www.co.mclennan.tx.us

            “Your Safety Comes First”

5. Offense:
6. Case #:
8. Instructions: Please Print

   If you need immediate assistance please call our dispatch line at 254-757-2555 or 911 depending on the nature of your emergency.

   When an offense has occurred and the suspect is still on the scene call 911. A Deputy will be sent to your location as soon as practical.

   If you are a victim of a non-violent crime, you may fill out and submit this form.  It can also be filled out in person and left with the receptionist and a Detective/Deputy will contact you.

   This form can also be printed and mailed back to the above address.

12. Offense Information
14. Date and Time of Offense
    Date and Time of Offense

    Date and Time of Offense
15. Location and Address of Offense*

    Please enter as much detail as possible regarding the location and/or address where the offense took place.

17. Type of Offense*

    1. Theft
    2. Scam
    3. Fraud
    4. Other

    Please select one or more of the following offense types related to your submission.  For any submissions involving physical abuse or sexual assault, you cannot use this form.  You must appear in person.

21. Complaint | Victim Information

    SSN and Valid Drivers License or Photo Identification will be obtained when contacted by an officer or Sheriff's Office staff member.

23. Name*
24. Email Address*

    If there is not an e-mail address to enter, please enter N/A.

25. Address*
27. City*
28. State*
29. Zip Code
30. Phone Number*
34. Witness Information

    SSN and Valid Drivers License or Photo Identification will be obtained when contacted by an officer or Sheriff's Office staff member.

    
    

36. Name*
37. Email Address*

    If there is not an e-mail address to enter, please enter N/A.

38. Address*
40. City*
41. State*
42. Zip Code
43. Phone Number*
45. Race*

    1. Black
    2. Hispanic
    3. Other/Unknown
    4. White
46. Sex*

    1. Female
    2. Male
47. Estimate Height and Weight*

    If you are unsure of this information, please enter unknown.

51. Suspect Information

    SSN and Valid Drivers License or Photo Identification will be obtained when contacted by an officer or Sheriff's Office staff member.

53. Name*
54. Email Address*

    If there is not an e-mail address to enter, please enter N/A.

55. Address*
57. City*
58. State*
59. Zip Code
60. Phone Number
62. Race*

    1. Black
    2. Hispanic
    3. Other/Unknown
    4. White
63. Sex*

    1. Female
    2. Male
64. Estimate Height and Weight

    If you are unsure of this information, please enter unknown.

68. Property Information - Damaged Property
70. Quantity
71. Value
72. Property Description and How Damaged
74. Quantity
75. Value
76. Property Description and How Damaged
80. Stolen | Lost Property
82. Quantity
83. Brand
84. Model
85. Serial #
87. Quantity
88. Brand
89. Model
90. Serial #:
92. Details of Occurrence

    Please answer the following: who, what, when, where and how the events occurred.

94. Details
96. Acceptance*

    1. Yes
97. I understand if I give a false report which is material to a criminal investigation I may be prosecuted for False Report to a Peace Officer or Law Enforcement Employee which is punishable by fine not to exceed $2,000 and /or confinement in jail for a term not exceed 180 days.
99. Date*
    Date
100. Full Name*

     Please enter your full name as text signature for submitting this form and accepting the policy information above.

Leave This Blank:


102. 1. Receive an email copy of this form.
103. Email address

     This field is not part of the form submission.

104. Submit Submit and Print

* indicates a required field