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2. 
3. Would you an officer to contact you?
   -- Select One --YesNo
4. Date and Time
   Please add the date and time of incident if known.
6. Would you like a report number emailed to you?
   -- Select One --YesNo
7. Type of Incident

   1. Hit and Run Crash
   2. Minor Theft
   3. Minor Vandalism
   4. Child Custody Dispute
   5. Fraud With no Loss
8. Other Incident
10. Incident Location
12. First Name
13. Middle Name
15. Last Name
16. Address
18. Date of Birth
    Date of Birth
19. City

    1. Big Lake
    2. Other
20. Other Than Big Lake
22. Phone Number
23. State

    1. MN
    2. Other
24. Other Than MN
26. Email Address
28. Upload Photo #1 Here
29. Upload Photo #2 Here
30. Upload Photo #3 Here
32. Describe what took place in detail.
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit Submit and Print

* indicates a required field