Anonymous Witness Form - WSU Tech WebForm Application

Date of Incident

Time of Incident :

Campus Location

You are not required to supply any of your personal information but even if you do, it will still be confidential if you indicated above.

Do you wish to remain anonymous? Yes No

Your Information

Your Name:

Sex: Male Female

Date of Birth:

Address:

City:

State:

ZIP:

Phone:

Contact Email:

Do you wish to be contacted? Yes No

Suspect Information

Suspect Appearance

Sex: Male Female Unknown

Do you know what the suspect looked like? Yes No

Please give a detailed description of the suspect.

Height:

Hair:

Race:

Ethnicity:

Do you know the suspect's identity? Yes No

Suspect Name:

SSN:

Date of Birth:

Address:

City:

State:

ZIP:

Phone:

Cell Phone:

Property Information

Please describe the Crime or Incident with as much detail as possible.*

List any known injuries, property damage, or loss.*