NYS DMNA Suspicious Activity Report (SAR)

   * = Required

Event Date

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec , : AM PM *

Reporting Individual

Last:* First:* MI:*
Phone #:* Email:* Address:

Did you witness the event? Yes No*

Incident Location

Location Name:* Address: City:* State:   New York Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *
Photo/Video Available:   Unknown Yes No *

Subject #1

Height:   Unknown Less than 4’ 6” 4’ 6” - 5’ 0” 5’ 1” - 5’ 6” 5’ 7” - 6’ 0” 6’ 1” - 6’ 6” Greater than 6’ 6” * Weight:   Unknown Less than 100lbs 100-125lbs 126-150lbs 151-175lbs 176-200lbs 201-225lbs Greater than 225lbs * Hair:   Unknown Black Blonde Brown Gray Red White Other * Eyes:   Unknown Black Blue Brown Green Hazel Glasses Other * Gender:   Unknown Male Female * Race/Ethnicity:   Unknown African American Arab Asian Caucasian European Hispanic Middle Eastern Native American Pacific Islander Other * US Citizen:   unknown Yes No * Build:   Unknown Small Medium Large X Large * Age:   Unknown Younger than 15 15-20 21-25 26-30 31-35 36-40 41-45 46-50 51-55 Older than 55 *
Other identifying information (scars/marks/tattoos, clothing, etc):

Identification (If known)

Last: First: MI:
ID Type: ID #:

Add subject (max 4)

Witness #1 (if applicable)

Last: First: MI:
Phone #: Email:
Unit/Activity: Position/Title:

Add witness (max 5)

Vehicle #1

Type:   None Aircraft Bicycle Boat Bus Car Motorcyle SUV Truck Van Other *

Make: Model: Year:   Unknown 1950-1960 1961-1970 1971-1980 1981-1985 1986-1990 1991-1995 1996-2000 2005-New *
License Plate: Color: Markings:

Add vehicle (max 4)

Details of Activity *