Ashland, Kentucky Police Department
Electronic Incident Reporting Form:

 
This report is for occurrences within the City of Ashland, Kentucky ONLY and must be within one year of actual occurance. WARNING: Falsely reporting an incident is a crime and punishable for up to one year in jail and a $500 fine.
* Indicates requred field
 
Exact address of incident:
Street:*  
City:*  
State:*  
Date occurred:*  
Time occurred:*  
Type of incident (theft, non-criminal property damage, harassment, etc.):*
 
Victim of incident:
Last name:*  
First Name:*  
Middle Name:*  
Date of Birth:*  
S.S. Number:*  
Address of incident:*  
City:*  
State:*  
Address of Victim:*  
City:*  
State:*  
Zip:*  
Home Phone:*  
Work Phone:  
Cell Phone:  
Fax:  
Email:  
Best time/way to be contacted by Police:*
Property involved (detailed description; serial #, make, model, etc)
 
Suspect(s):
Suspect Name 1:  
Date of Birth 1:*  
S.S. Number 1:*  
Address 1:  
City 1:  
State 1:  
Zip 1:  
Phone 1:  
 
Suspect Name 2:  
Date of Birth 2:*  
S.S. Number 2:*  
Address 2:  
City 2:  
State 2:  
Zip 2:  
Phone 2:  
Describe the incident:*
 
 
Ashland Police Department © 2007 P.O. Box 1864 Ashland, Kentucky 41105-1864 | (606) 327-2020 | Fax (606) 324 - 5500

City of Ashland, Kentucky
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