Skip to Main Content
About EB
Community
Departments
Government
Recreation & Parks
Public Safety
Home
Form Center
Form Center
Search Forms:
Search Forms
Select a Category
All Categories
Contact the Township Council
Contact Us
Economic Development
Municipal Court
Planning & Engineering
Police Department
Public Works
Recreation & Parks Forms
By
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Sign in to Save Progress
EBPD Incident Report
This form has been modified since it was saved. Please review all fields before submitting.
Steps
1.
Online Reporting
This section is complete
This section is incomplete
2.
Reporting Person's Information
This section is complete
This section is incomplete
3.
Additional Contacts
This section is complete
This section is incomplete
4.
Property Information
This section is complete
This section is incomplete
5.
Incident Information
This section is complete
This section is incomplete
Online Reporting
The Township of East Brunswick Police Department looks forward to accepting your online report. Not all crimes and incidents can be reported online and this service is not intended to discourage you from requesting a response to your home or business to file a report.
Call the Township of East Brunswick Police Department at 732-390-6900, if the incident you wish to report does not meet the criteria for online reporting, or if you prefer an Officer respond to your home or business within the Township. A report can also be made in person at Police Headquarters located at 1 Civic Center Drive, East Brunswick, NJ 08816.
Continue
Reporting Person's Information
First Name
*
Middle Name
Last Name
*
Home Address
*
City
*
State
*
Zip Code
*
Home Phone Number
*
Cell Phone Number
Email Address
*
Date of Birth
*
Date of Birth
Sex
*
-- Select One --
Female
Male
Race
*
-- Select One --
White Hispanic
White Non Hispanic
Black Hispanic
Black Non Hispanic
Native American/Eskimo Hispanic
Native American/Eskimo Non Hispanic
Asian Hispanic
Asian Non Hispanic
SSN
Driver License Number
Licensing State
Business Information
Complete the below fields if you are responsible for reporting this incident for your employer, government agency, or your own business.
Business Name
Business Address
City
State
Zip Code
Main Phone Number
Alternate Phone Number
Continue
|
Go Back
Additional Contacts
Involved Person(s)
Provide contact information for any additional person(s) involved in the incident.
First Name
Middle Name
Last Name
Home Address
City
State
Zip Code
Home Phone Number
Cell Phone Number
Date of Birth
Date of Birth
Sex
-- Select One --
Female
Male
Race
-- Select One --
White Hispanic
White Non Hispanic
Black Hispanic
Black Non Hispanic
Native American/Eskimo Hispanic
Native American/Eskimo Non Hispanic
Asian Hispanic
Asian Non Hispanic
First Name
Middle Name
Last Name
Home Address
City
State
Zip Code
Home Phone Number
Cell Phone Number
Date of Birth
Date of Birth
Sex
-- Select One --
Female
Male
Race
-- Select One --
White Hispanic
White Non Hispanic
Black Hispanic
Black Non Hispanic
Native American/Eskimo Hispanic
Native American/Eskimo Non Hispanic
Asian Hispanic
Asian Non Hispanic
First Name
Middle Name
Last Name
Home Address
City
State
Zip Code
Home Phone Number
Cell Phone Number
Date of Birth
Date of Birth
Sex
-- Select One --
Female
Male
Race
-- Select One --
White Hispanic
White Non Hispanic
Black Hispanic
Black Non Hispanic
Native American/Eskimo Hispanic
Native American/Eskimo None Hispanic
Asian Hispanic
Asian Non Hispanic
Continue
|
Go Back
Property Information
Stolen Item(s) Information
Complete the below fields for any incident involving a stolen item(s).
Item Type 1
-- Select One --
Currency
Jewelry
Furs
Clothing
Auto
Miscellaneous
Item Type 1 - Value ($)
Item Type 2
-- Select One --
Currency
Jewelry
Furs
Clothing
Auto
Miscellaneous
Item Type 2 - Value ($)
Item Type 3
-- Select One --
Currency
Jewelry
Furs
Clothing
Auto
Miscellaneous
Item Type 3 - Value ($)
Item Type 4
-- Select One --
Currency
Jewelry
Furs
Clothing
Auto
Miscellaneous
Item Type 4 - Value ($)
Motor Vehicle Information
Complete the below fields for any incident involving a motor vehicle.
Make
Model
Type
VIN
Color
License Plate #
Licensing State
Registered Owner's Name
Registered Owner's Address
City
State
Zip Code
Home Phone Number
Cell Phone Number
Continue
|
Go Back
Incident Information
Incident Type
*
-- Select One --
Credit Card Theft
Criminal Mischief
Custody Dispute
Cyber Harassment (except domestic violence)
Dispute (civil, neighbor, landlord/tenant)
Follow-up Report
Fraud, Embezzlement or Bad Checks
Harassment (except domestic violence, threats with a weapon or bomb threats)
Identity Theft
Lost Property (except lost firearms or other weapons)
Property Damage - Non Criminal
Reports for Insurance Purposes (insurance claims)
Shoplifting Under $1,000
Simple Assault (except domestic violence)
Theft under $1,000
Report Type
*
-- Select One --
Original - This is the first report that is being filed for this incident.
Supplement - You are adding additional lost, stolen or damaged property to a previous report which was filed online.
Previous Incident Report Number
Previous Incident Report Date
Incident Date and Time
If you are unsure of the specific date and/or time of the incident please provide a start and end date and time. Otherwise, only complete the first incident date and time fields.
Incident Date
*
Incident Date
Incident Time
*
Incident Date
Incident Date
Incident Time
Incident Location
A valid address within the Township of East Brunswick must be entered below. If the incident occurred outside of the Township of East Brunswick, it must be reported to the local law enforcement agency where the incident occurred. Reports may be rejected if an invalid address is provided or the incident occurred in another jurisdiction.
Business Name
Incident Address
*
Incident location must be located in East Brunswick, NJ.
City
*
State
*
Zip Code
*
Incident Details
Police reports should contain accurate, detailed, and informative information about a crime or incident. Effective police reports should always answer the questions who, what, where, when, how, and why. If any of these six questions cannot be answered, the report should contain as much information as possible. Reports that do not contain accurate, detailed, and informative information will be rejected.
Narrative
*
Electronic Signature Agreement
*
By checking the "I agree" box below, you agree and acknowledge that 1) the information you are providing is not urgent or requiring prompt or immediate attention, and you understand that you should call 911 or contact the appropriate authorities by phone if this is time sensitive information, and 2) making a false report to law enforcement or other organizations which deal with emergencies involving danger to life or property is a serious offense and may be punishable by law.
I agree.
Electronic Signature
*
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
Submit and Print
|
Go Back
* indicates a required field
Township Home Page
Recreation & Parks
Public Safety
Arrow Left
Arrow Right
[]
Slideshow Left Arrow
Slideshow Right Arrow
