Durham Regional Police Service


	Road Watch - Online Citizen Report Form

*Fields marked with are mandatory.**
"Road Watch" is a community road safety program sponsored by local businesses and agencies in cooperation with the Durham Regional Police Service and the Ontario Provincial Police.
Time of Incident *
Location of Incident *	At street name(s) *
Vehicle Information

Vehicle Involved *
Plate#		Province:*
Vehicle Year		Vehicle Color
Make		Model
Description of Driver
Sex		Age
What Happened*
Incident Reported By

This area MUST be completed. Road Watch will not disclose your personal information. Your email address will be used as your "signature" when submitting this form electronically.
Surname*		First Name*
Address*		Email*
City/Town*		Postal Code*
Phone#*		Business#


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	©2012 Durham Regional Police Service, Ontario, Canada. All rights reserved. Contact us: Emergency - 911, Non-Emergency - Durham Local: (905) 579-1520 Toll Free: 1-888-579-1520