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BELLEVUE POLICE DEPARTMENT
Bellevue, Nebraska

Online Drug Activity Report Form

The following form allows you to submit information to the Bellevue, Nebraska Police Department regarding suspected drug activity occurring within the City of Bellevue.


LOCATION OF ACTIVITY

Where is the suspected drug activity occurring:*
Business Name (If applicable):
Street Address or Nearest Intersection:*
Apartment Number (If applicable):
This activity is occurring (Check all that apply):*


INTELLIGENCE INFORMATION

Please do not guess or assume the answers to the following questions.  Only provide answers to the questions which you know to be true based upon factual information.

Security / Safety Concerns (Check all that apply): *
Other Security / Safety Concerns (Complete if you checked "Other" above):
What type of drugs are being sold or used at this location:*
What days do most of the drug activity occur (Check all that apply):*
What time of the day does most of the drug activity occur (Check all that apply):*
Drug Dealer's Name (If known):
Drug Dealer's Nickname or Street Name (If known):
Drug Dealer's Age or Age Range (If known):
Drug Dealer's Race (If known):
Drug Dealer's Gender (If known):
Drug Dealer's Physical Description (Height, weight, hair color and length, eye color, scars, marks, tattoos):
Drug Dealer's Address (If known):
Drug Dealer's Phone Number (If known):
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Type of Phone Number:
Drug Dealer's Phone (#2):
-
Type of Phone Number (#2):
Drug Dealer's Phone (#3):
-
Type of Phone Number (#3):
Drug Dealer's Vehicle Information (Year, make, model, color, license plate, or any other distinguishing features, and where it is commonly parked):
Please provide any additional information you feel may be important to the Detective assigned to investigate this complaint:


TELL US ABOUT YOURSELF

We respect your right to privacy and care about your personal safety.  You have the option to remain anonymous; however, it may be beneficial for a Detective to discreetly contact you to obtain additional information regarding your complaint.  Keeping this in mind, if provided, your contact information will be kept confidential and will not be disclosed without your consent.

May we contact you? (Note: Please keep in mind that you may still remain anonymous):*
If you selected "Yes" above, how would you prefer to be contacted:
Do you wish to remain anonymous:
Are you willing to testify in court:
Name:
Address:
Home Phone:
-
Work Phone:
-
Cell Phone:
-
E-mail:
Recaptcha Word Verification: