Crime Incident Report Template

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Crime Incident Report Template

A crime incident report notes the details of a crime for a company or organization’s internal records. This document can be used by landlords, business owners, contractors, caretakers, and educators when they witness criminal activity. The document is separate from any official police report regarding the incident and is kept for personal or professional records.

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Last updated August 21st, 2025

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A crime incident report notes the details of a crime for a company or organization’s internal records. This document can be used by landlords, business owners, contractors, caretakers, and educators when they witness criminal activity. The document is separate from any official police report regarding the incident and is kept for personal or professional records.

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Reporting a Crime

When a crime is witnessed, a police report should be filed with the local law enforcement agency. If it’s an emergency, the witness or victim should call 911.

Criminal Incident Examples

  • Drug use or trafficking
  • Illegal weapons
  • Threatening behavior or assault
  • Property damage or vandalism
  • Theft

Sample

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CRIME INCIDENT REPORT FORM
INDIVIDUAL FILING REPORT

Full Name: [FULL NAME] Title/Role: [TITLE/ROLE]
Signature:                                                           Date: [MM/DD/YYYY]

INCIDENT DETAILS
Date of Incident: [DATE OF INCIDENT]      Time: [TIME] ☐ AM ☐ PM

Location: [LOCATION]

Describe the Incident: [DESCRIBE THE INCIDENT]

PARTIES INVOLVED
Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [EMAIL] Address: [ADDRESS]
Identification: ☐ Driver’s License No. [DL NUMBER] ☐ Passport No. [PASSPORT NUMBER] ☐ Other: [OTHER]

Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [EMAIL] Address: [ADDRESS]
Identification: ☐ Driver’s License No. [DL NUMBER] ☐ Passport No. [PASSPORT NUMBER] ☐ Other: [OTHER]

INJURIES
Was anyone injured? ☐ Yes ☐ No If yes, describe the injuries: [INJURY DESCRIPTION]

WITNESSES
Were there witnesses to the incident? ☐ Yes ☐ No

If yes, enter the witnesses’ names and contact info:

  1. Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [EMAIL]
  2. Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [EMAIL]

POLICE/MEDICAL SERVICES
Police Notified?☐ Yes ☐ No

If yes, was a report filed? ☐ Yes ☐ No

Was medical treatment provided? ☐ Yes ☐ No ☐ Refused

If yes, where was medical treatment provided? ☐ On site ☐ Hospital ☐ Other: [OTHER]