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Drug Information Reporting Form
If you have information regarding drug activity occurring in Salina please use this form to tell us about it.
Thank you for your cooperation in giving us this information. We appreciate your concern and effort to make your community a better place.The reason we created this form is to ensure that we can get as much infomation as possible. Try to answer as much as you're able to answer and please answer only what you're certain of.
All information you provide will be held in strict confidence.
Tell us where the drug activity is occurring
Inside Private Residence:
Alley or Driveway:
Hallway or Corridor:
Park or Wooded Area:
Sidewalk or Street Corner:
From a Vehicle:
If Other (please explain):
Street Address or Business Name:
Apartment Number (if applicable):
Security at this location
Please do not guess or assume the answers to the following questions.
Answer only if you know. Please check if any of the following applies
There are Guns at This Location:
There are Dogs Inside this Location:
The Doors are Reinforced or Gated:
The Windows are Reinforced or Gated:
The Premises are Video Monitored:
What Types of Drugs are Being Sold?
If Other (please specify):
What Day Does Most of The Activity Occor?
What Time Does The Most Activity Occur?
12:00am - 2:00am:
2:00am - 4:00am:
4:00am - 6:00am:
6:00am - 8:00am:
8:00am - 10:00am:
10:00am - 12:00pm:
12:00pm - 2:00pm:
2:00pm - 4:00pm:
4:00pm - 6:00pm:
6:00pm - 8:00pm:
8:00pm - 10:00pm:
10:00pm - 12:00am:
24 Hour a Day:
Drug Dealer's Information
Drug Dealer's Name (if known):
Drug Dealer's Nickname or Street Name:
Drug Dealer's Age or Age Range:
Drug Dealer's Race:
Please Select One
Drug Dealer's Sex:
Please Select One
Drug Dealer's Phone Number or Pager Number:
(please format as 123-456-7890)
Drug Dealer's Address:
Drug Dealer's Physical Description:
Please tell us about any vehicles used by the dealers.
Provide any information such as year, make, model, color, license plate, or other descriptive information
Please include any additional information that would be helpful in this investigation.
Such as, who else is living at the residence that is actively involved in dealing narcotics; who else is living in the residence; who are the people purchasing the drugs and any other people we may contact.
Your Personal Information
May We Contact You?:
Please Provise The Following Information if you Want to be Contacted:
Work Phone Number:
Home Phone Number:
DISCLAIMER: Our site allows you to provide information about drug use or production anonymously. The Drug Task Force and its member agencies will determine, in its sole discretion, whether or not it will investigate any such reports. Information provided anonymously may be shared among the member agencies of the Task Force or with other public agencies. Any information you provide will be used only to respond to you or to investigate a possible crime.
300 W. Ash Street
Salina, KS 67401
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