Anonymous Narcotics Report

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Rockville City Police Department

Use this form to report narcotics activity or drug dealers that you observe in the City of Rockville. The information you provide will help the Rockville City Police Department successfully respond to the problem of drug trafficking in your community. Please be observant and complete as much of the form as possible. You may submit this form as often as is necessary.

The information you submit will be forwarded to the Municipal Drug Task Force for further investigation and enforcement. Rockville City Police officers from this unit may contact you for additional information if you elect to provide your name in the space provided below. If you elect to remain anonymous, however, be assured that the information you provide will be acted upon.

In any case, all information will be held in STRICT CONFIDENCE.

Thank you for helping us help you.

Narcotic Location

EXACT street address where dealing occurs

check all that apply

on street	rear driveway	from vehicle
inside premises	other

If other, describe

Where are drugs hidden?

Have you seen guns at this location?

[ Yes ] [ No ]

Are there dogs inside these premises?

[ Yes ] [ No ]

Are the doors reinforced or gated?

[ Yes ] [ No ]

Are the windows reinforced or gated?

[ Yes ] [ No ]

Describe how the drug sale occurs:

Drug Activity

Hours of the day with HEAVIEST traffic

Indicate a.m. or p.m.

Day of week

with HEAVIEST traffic

Drug Activity Nature

Primary Drug

If other, please describe:

Vehicles Used

Manufacturer

Model Name

Vehicle Color

License State

License Number

Unique Features

Dealer Identity

Dealer First Name

Dealer Last Name

Dealer Nickname

Dealer Age

Dealer Race and Sex

Unique Features

Dealer Address

Dealer Phone

Dealer Pager

Your Information

This information is optional. Your confidentiality is assured. It will only be used by us if we have any questions.

Your First Name

Your Last Name

Your Address

Your ZIP code

Daytime phone

e-mail

Rockville City Police
Department of Public Safety
111 Maryland Avenue, Rockville, MD 20850
In case of emergency, call 911
240-314-8900 (non-emergency)