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2. Incident Date and Time:*
   Incident Date and Time:

   Incident Date and Time:
3. Drug Type (If known):
5. Frequency:*

   1. Single Incident
   2. Sporadic
   3. Weekly
   4. Daily
   5. Mornings
   6. Afternoons
   7. Evenings
   8. Nights
   9. Throughout Day and Night
6. Location Type:*

   1. Business
   2. House
   3. Apartment/Townhouse
   4. Other
7. Did you:*

   1. Witness
   2. Know Party involved
   3. Indirectly learn about
9. Address:*
11. Vehicle(s) Description:
13. Person(s) Description
15. Other Information:
17. Name and Contact Information (OPTIONAL):

19. DISCLAIMER: This tip is given in good faith and all details are greatly appreciated. Individuals are given an option to include contact information to possibly provide more information or clarify what has been included in this tip. Understand our investigators will not be following-up with results from these tips. You will not be able to call in for information on investigation endeavors.

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21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

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