Pocatello Police Department

911 N 7th Avenue
Pocatello, Idaho

208-234-6100

You must answer the following questions before filing a report:

Is this crime taking place in person right now?

Select  Yes No

To file your harassment/discrimination report, please provide as much information and detail as possible. Fields marked with an asterisk (*) are required. Incomplete reports will not be filed. If you have any questions, please contact the Pocatello Police Department at 208-234-6121.

Attachments

If you have photographs or documents to attach, please upload them below. (LIMIT: 5 files no more than 7MB each)

Drop files here or click to upload.

Reporting Party

First Name
Last Name
Home Address
City
State	Unspecified - 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
ZIP Code
Daytime Phone
Alternate Phone
Email Address
Alternate Email
Gender	Unspecified - Male Female
Date of Birth	mm/dd/yyyy
Driver's License State	Unspecified - 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
Driver's License Number

Incident Information

Time Frame of Incident	Between and
Incident Location	Please provide a description of the exact location where the incident occurred, being as specific as possible.
Number of Harassing or Discriminatory Incidences
Incident Description	Please provide a detailed description of the harassment or discrimination.
Basis for Claim of Discrimination (if applicable)	Age (40+) Color (different skin shade in same race) Disability Gender Expression Gender Identity National Origin (ethnicity or ancestry) Pregnancy Race Religion Retaliation Sex: Female Sex: Male Sexual Orientation

Suspect Information

Suspect's Name (if known)
Contact Method	Please provide at least one of the following ways the suspect has been contacting you: Suspect's Physical Location Suspect's Phone Number Suspect's Email Address Suspect's Facebook Username Suspect's Other Social Media Account

Acknowledgment

Acknowledgement #1	I have reviewed my report to ensure that all pertinent details are included, such as any witnesses, photographs, video, vehicle descriptions, suspect descriptions, etc., as the decision to close this case or assign it for further investigation will be made based on the content provided.
Acknowledgement #2	I acknowledge that knowingly falsifying a crime report is punishable by Idaho State law.