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1. Please describe the drug problem you are encountering. 2. When is this occurring? Days Nights Time: Day(s) of the week this activity is occurring:
3. Can you be specific on the location where this is occurring? Address?
4. Do you know the names of the person(s) involved? Please include their "street name" or nickname if any. Can you describe them? (Race, sex, height, weight, hair color, age...)
5. Please list the pager number, cell phone number or home phone number of the subject(s) involved in this activity, if known.
6. Are there any vehicles being used or involved? Do you know the tag numbers? Can you describe the vehicles? (Car, truck, color, year, model, 2 or 4 door).
7. Can we talk to you? If yes, then please include the following information. THIS INFORMATION IS NOT REQUIRED TO SUBMIT THIS FORM!!! Name: Email: Phone:
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