Melbourne Police Department Online Incident Report

Print
Press Enter to show all options, press Tab go to next option
Please correct the field(s) marked in red below:

This website is not monitored live by law enforcement officers. IF YOU NEED IMMEDIATE ASSISTANCE CALL 911.

Please use this form to submit information about non-emergency incidents. An officer will follow up with you either via e-mail or by phone during regular business hours, Monday through Friday, 8:30 a.m. – 5 p.m.


Please fill-in the form completely, then submit by using the SUBMIT at the bottom of the page. Please Note: (*) indicates responses are required. If a required field does not pertain to the incident, please type "n/a."
 *
Please fill-in the form completely, then submit by using the SUBMIT at the bottom of the page. Please Note: (*) indicates responses are required. If a required field does not pertain to the incident, please type "n/a."
Type of Incident:
 *
Type of Incident:
Additional Information About the Incident:

Your LAST NAME:
 *
Your FIRST NAME:
 *
Your Middle Initial:
Your Date of Birth:
 *
Gender
 *
Gender
 *
Contact Information:
 *
Contact Information:

PROPERTY INVOLVED
PROPERTY INVOLVED



Briefly describe the details of the incident in the box below.
 *
  1. To receive a copy of your submission, please fill out your email address below and submit.
    CAPTCHA
    Change the CAPTCHA codeSpeak the CAPTCHA code