3. Date of Crime If day and/or month is uncertain or unknown, leave blank and check the "Month and/or day unknown" box. Month: January February March April May June July August September October November December Day: 01020304050607080910111213141516171819202122232425262728293031 Year (required): 20082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971 Month and/or day unknown: 4. Location of Crime City: County: State/Territory (required): 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 New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------- Guam Puerto Rico Other U.S. Territory 5. Victim Information If there are multiple victims for the same crime enter each victim individually. The "multiple victims" submission button at the bottom of the form will duplicate the filled out form for another victim, with the exception of the information in sections 5 and 8, allowing easy reporting of multiple victims. First Name (use "Jane" or "John" "Doe" for sexual crimes) Last Name Sex: -- Male Female Age: (round off to the nearest year. For babies less than 6 months use "0") Residency: State/Territory: 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 New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------- Guam Puerto Rico Other U.S. Territory (required but use the blank if unknown) Race or Ethnicity: Caucasian Black Asian American Indian Hispanic Other Victim is part of law enforcement 6. Perpetrator Data First Name Middle Name Last Name Sex -- Male Female Age: Nationality (select one) Mexico ****** Argentina Australia Bahama Canada Columbia Dominican Republic Ecuador El Salvador Guatamala Hondurus Iran Iraq Jamaica Panama Peru Puerto Rico Syria Turkey Venezuela ****** Asia Africa Europe South America ****** other unknown nationality unknown but most likely an illegal alien nationality unknown but confirmed as an illegal alien Arrest Status (required):
Suspected/Wanted Charged Convicted/Died in Crash Perpetrator: Had been previously ordered deported but did not get deported Had been previously deported but returned had prior felony charges or conviction was DUI/DWI when accident occurred was DUI/DWI when accident occurred and had one or more prior DUI/DWIs was a hit-and-run driver. Multiple Perpetrator Information: Please enter any aliases here. If there were multiple perpetrators, please provide data on the additional perpetrator(s). This information is for reference only and can not be searched or sorted on. 7. Crime Description Provide a title line of the crime, a summary description of the crime, and additional information on the victim(s), the crime, and the perpetrator(s) as necessary. Note the character limitations. Spaces count as a character.
Title line of crime. (required) 100 character limitation
Details of the crime. (required) 5000 character limitation. NOTE: use of copyrighted material must give credit to original source.
8. Crime Documented or Reported by...(required) Crimes must be documented. For reported crimes, include publication date, news agency and location if done by a broadcasting media, title of article, and the reporter's name, if available. Put the Internet link in the following line, even if the link went dead after you captured it. Include police and court report numbers, if known. Thus the generic documentation format is: 23JUNE08, Rocky Mountain News, Denver, Colorado Illegal Alien Convicted of Crime, by Bill Jones http://www.asdfw34tt434t34t.com 9. Pictures
I am interested in receiving periodic information on VOIAC. (requires e-mail address.)
I am interested in becoming involved in VOIAC. (Requires Name and E-mail and/or Telephone)
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