Wausau Police Department

Citizen Self-Report Form

* Required

Due to investigative procedures, you may use this form to report ONLY the following types of incidents:

Theft (not by force or break-in to building)
Car break-in (not auto theft)
Vandalism or damage to property or to vehicle
Lost \ Missing property

If any of the following is true, DO NOT USE this form. Call for a police officer to respond (715.261.7800).

You have suspect information
There was injury to a person
You have suspect vehicle information (license number, etc.)
There was an eyewitness to the incident
There was a theft by force, break-in to building, or auto theft

Contact Information *

I am the Victim \ Reporting Person \ Property Owner (Check all that apply)

First Name

Last Name

Gender

Birth Date (MM/DD/YYYY)

Address

City , ZIP

Phone 1 (Home)

Phone 2 (Work)

Phone 3 (Cell)

Incident *

Report Type: Theft \ Vehicle Break-in \ Vandalism \ Damage to Property \ Lost/Missing Property

Date Incident Occurred: Time: AM PM

Location Type: Residence \ Business \ School \ Parking Lot \ Other

Address Where Incident Occurred: (Number, Street, Apt)

Briefly Describe the Incident That Occurred:

Characters Left

Property Descriptions

Property #1: Damaged \ Stolen \ Lost or Missing

Make: Model: Serial#

Description: Est. Value: $

Property #2: Damaged \ Stolen \ Lost or Missing

Make: Model: Serial#

Description: Est. Value: $

Property #3: Damaged \ Stolen \ Lost or Missing

Make: Model: Serial#

Description: Est. Value: $

Property #4: Damaged \ Stolen \ Lost or Missing

Make: Model: Serial#

Description: Est. Value: $

Property #5: Damaged \ Stolen \ Lost or Missing

Make: Model: Serial#

Description: Est. Value: $

Property #6: Damaged \ Stolen \ Lost or Missing

Make: Model: Serial#

Description: Est. Value: $

Property #7: Damaged \ Stolen \ Lost or Missing

Make: Model: Serial#

Description: Est. Value: $

Vehicle Descriptions

Vehicle #1: Make: Model: Year:

Color: License# VIN:

Damage: Damage Est: $

Vehicle #2: Make: Model: Year:

Color: License# VIN:

Damage: Damage Est: $

Vehicle #3: Make: Model: Year:

Color: License# VIN:

Damage: Damage Est: $

Send Request

Please complete form as much as possible before submitting.
By submitting this form you certify under penalty of law that all the information supplied on this report is true and correct to the best of your knowledge.