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File a Report – Crime

Home » Public Safety » Police Department » File a Report – Crime

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This report form permits you to quickly and easily report a crime in which you have been a victim. A police officer of the Bartlesville Police Department will review this report. If any other information is needed the Bartlesville Police Department will contact you.

If the situation is in need of immediate assistance, contact the police immediately by calling 911 or calling 918.338.4001 for non-emergencies

Directions
1. CALL 911 IF THIS CRIME IS IN PROGRESS OR IS SERIOUS IN NATURE. VIOLENT CRIME SUCH AS ASSAULT, ROBBERY, OR ANY CRIME INVOLVING A WEAPON CANNOT BE REPORTED HERE. CALL POLICE IMMEDIATELY AND AN OFFICER WILL BE DISPATCHED.
2. COMPLETE ALL SECTIONS THAT PERTAIN TO THE CRIME YOU ARE REPORTING.
3. ANSWER ALL QUESTIONS.
4. WHEN FINISHED CLICK SUBMIT BUTTON TO AUTOMATICALLY E-MAIL YOUR REPORT TO policerecords@cityofbartlesville.org
It is UNLAWFUL to FALSELY Report a CRIME. YOUR Completion of this Report indicates YOU will assist in the Prosecution of this CRIME.
IS THE VICTIM OF THIS CRIME A BUSINESS OR COMPANY?*
- Yes
- No
Business Name*
Business Address*
Street Address Address Line 2 City State ZIP Code
Business Phone*

Crime Reported*
List Your Reporting Party Information
I am also a VICTIM in this CRIME*
- Yes
- No
Name*
First Middle Last
Your Email Address*
Date of birth*
MM slash DD slash YYYY
Race*
Sex*
Hair Color*
Eye Color*
Hispanic
- Yes
- No
Height
Weight
Change to Native American? If yes what tribe and roll number:
Home Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Cell Phone*
Employment Address
Street Address Address Line 2 City State ZIP Code
Work Phone

Where there other identifiable individuals involved?*
- Yes
- No
1st Individual Involved*
- Individual
- Victim
- Witness
- Suspect
- NA
1st Individual Info
Name
First Middle Last
Date of birth
MM slash DD slash YYYY
Marital Status
Race
Sex
Hair Color
Eye Color
Hispanic
- Yes
- No
Height
Weight
Change to Native American? If yes what tribe and roll number:
Home Phone
Cell Phone
Employment Address
Street Address Address Line 2 City State ZIP Code
Work Phone
2nd Individual
Was there a second identifiable individual?*
- Yes
- No
2nd Individual Info
2nd Individual Involved*
- Individual
- Victim
- Witness
- Suspect
Name
First Middle Last
Date of birth
MM slash DD slash YYYY
Race
Sex
Hair Color
Eye Color
Hispanic
- Yes
- No
Height
Weight
Change to Native American? If yes what tribe and roll number:
Home Address
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Employment Address
Street Address Address Line 2 City State ZIP Code
Work Phone

Was there a vehicle involved in this crime?*
- Yes
- No
Vehicle Info
Registered Owner
Registered Owner Address
Street Address Address Line 2 City State ZIP Code
Tag Number
Tag Year
Vehicle Year
State
Vehicle Style
Make
Model
Color
Distinguishing Marks
Estimated Value

When and where did this crime occur?
If you know approximately what time the crime happened:

: Hours

Minutes

AM/PM
If you do not know the approximate time, what hours did the crime happen between?

Example: You go to sleep at 11:00 PM on Friday night. You wake up Saturday morning at 8:00 AM and find out you are the victim of a crime. The crime happened BETWEEN Friday at 11:00 PM AND Saturday at 8:00 AM)
Date of Occurrence
MM slash DD slash YYYY
Hidden
Day of the Week (on or about)
Hidden
Month
Hidden
Year
Location / Address
APT
City & State
Zip

List the property that was lost, stolen, or damaged*

Description	Serial Number	Value	Lost/Stolen/Damaged

Have any other reports been made on this crime?*
- Yes
- No
By whom?*
- Police Officer
- Yourself
Did you or someone else see the suspects commit the crime?*
- Yes
- No

List everyone that saw or may have first-hand information about the crime:*

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Describe exactly what happened. Include all details of the crime.*
EXAMPLE: I woke up at 8:00 AM and found my car broken into. They broke my left front window with a rock to get in. They stole my stereo and tapes. My neighbor saw two men in my car at 7:00 AM.

This Example tells:
WHEN it happened
WHAT was stolen or damaged
WHERE the crime occurred
WHO did what
WHO saw what
HOW they did it
WHY if known
WHAT they used to do it
Must read and accept before submitting:*
It is unlawful under Oklahoma State Statute 21 OS.589-to falsely report a crime and or provide false information thereof. Any person convicted of violating the provisions of this subsection shall be guilty of a misdemeanor punishable by imprisonment in the county jail for not more than ninety (90) days or by a fine of not more than Five Hundred Dollars ($500) or by both such fine and imprisonment.
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