Lost Property Report (PDF)

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READING POLICE DEPARTMENT

LOST PROPERTY REPORT

R.O. USE:

SCANNED:

OFFENSE CLASSIFICATION:

8805

U.C.R CODE

PRIMARY OFFENSE TITLE:

LOST PROPERTY

 

ASSIGNMENT NUMBER:

DATE AND TIME OFFENSE REPORTED

DATE AND TIME OFFENSE OCCURRED

DAY(S) OF WEEK

 

MONTH

DAY

YEAR

TIME

M:

D:

Y:

T:

 

DISTRICT:

CENSUS TRACT:

M:

D:

Y:

T:

 

LOCATION OF LOSS:

TYPE OF PREMISES:

WHERE LOSS IS REPORTED:

INDICATE WITH THE PROPER CODE A PERSON’S RELATIONSHIP TO THE INVESTIGATION:

C –COMPLAINANT      V-VICTIM     W-WITNESS     S-SUSPECT        N-NAME OF INTEREST

NAME

ADDRESS

RACE

SEX

D.O.B.

TELEPHONE NUMBER(S)

CODE

 

 

 

 

 

H:
W:

 

 

 

 

 

 

 

H:
W:

 

 

 

 

 

 

 

H:
W:

 

 

NARRATIVE DESCRIBE BELOW THE CIRCUMSTANCES SURROUNDING YOUR PROPERTY LOSS

 

 

 

 

 

 

 

 

 

 

**** ITEMIZE ALL PROPERTY LOST ON THE REVERSE SIDE OF THIS REPORT ****

 

INSURANCE CARRIER PROVIDING COVERAGE:

NAME & ADDRESS OF INSURANCE CARRIER’S AGENT:

AGENT’S TELEPHONE #:

BY SIGNING AND SUBMITTING THIS REPORT OF LOST PROPERTY TO THE READING POLICE DEPARTMENT I VERIFY THAT THE FACTS SET FORTH HEREIN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE OR INFORMATION AND BELIEF.  THIS VERIFICATION IS MADE SUBJECT TO THE PENALTIES OF SECTION 4904 OF THE CRIMES CODE OF PA (18 PA.C.S. §4904) RELATING TO UNSWORN FALSIFICATION TO AUTHORITIES.

 

SIGNATURE OF COMPLAINANT:                                                                                                                                                                                                                DATE REPORT FILED:

 

 

WITNESSING OFFICER:

COMPUTER #:

REVIEWING SUPERVISOR:

COMPUTER#:

CLEAN ENTRY

DATE & TIME:

BY WHOM:

MESSAGE #:

RADIO
G.B.

DATE & TIME:

BY WHOM:

RPD
A2-LP

(REV: 12/2006)

BELOW FOR RECORDS USE ONLY

PROCESSED BY:

Q.C. BY:

E-10 BY:

CLASSIFICATION CHANGED:   ☐NO

YES, TO:

ENTERED BY:

PROPERTY BY:

SPECIAL DISTRIBUTION BY:

S DAILY BULLETIN BY:

 

Distribution:  Original Report to Records     Two-Sided Photocopy to Complainant

 

ITEMIZE ALL PROPERTY LOST ON THIS SIDE OF THE REPORT

 

CODE

PROPERTY TYPE

PROPERTY DESCRIPTION AND IDENTYFIYING NUMBERS

DOLLAR VALUE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RPD A2-LP (REVERSE)