CITIZEN SELF-REPORT FORM INSTRUCTIONS

Please be advised that according to West Virginia State code §61-6-20 that falsely reporting an emergency incident is a misdemeanor, and, upon conviction thereof, the individual shall be fined not more than five hundred dollars or confined in the county jail not more than six months, or both fined and confined. False reporting of an emergency incident is defined as reports to a law-enforcement officer or agency the alleged occurrence of any offense or incident which did not in fact occur.

What is this form used for?

This form is intended to provide a convenient option for citizens to report certain crimes and/or incidents. This report form may be used for larcenies (less than $1000.00 in value), destruction of property, or any offense that you are directed to do so by the Putnam County 911 dispatcher. Crimes/incidents reported on this form must have occurred within Putnam County, West Virginia.

What is this form NOT used for?

This form is not to be used for violent crimes against a person (such as battery or stalking), a missing person, when there is evidence to be collected, when the serial number of stolen property is available, or reporting the theft of medication. For reporting Internet fraud, including suspicious e-mails without a known local source, visit the FBI Internet Crime Complaint Center at www.ic3.gov. If you are reporting an immediate emergency, you should always dial 9-1-1.

Who may complete this form?

Only adults (18 years old and above) who are the owner of the property, a family member, or legal guardian may make a report. Will an officer contact me? Not necessarily. An officer may contact you if the department needs to follow up with you about a suspect or information in your case. You may also specifically request on the report form that an officer contact you. In this case, the department endeavors to respond as timely as possible but cannot promise any specific response or response time.

What do I need to begin the report?

You must know what type of incident you are reporting, the value of the damaged/stolen property, and when and where the incident occurred.

How do I get started?

Fill out the form completely and accurately. Please print neatly and legibly. Write a statement providing us with as much information as you know about this case in the space provided. If you provided suspect information, you must describe why you believe the individual is involved. A suspect is an individual who is linked to the crime by eyewitness testimony or physical evidence. If lacking an eyewitness or physical evidence, please list your suspicions in the narrative section.

When do I get an incident/offense case number?

You should be able to obtain an incident/offense case number for your report after one (1) business day and a full copy of the report within three (3) business days of returning this form to the Putnam County Sheriff’s Office.