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General City Related Issue
Report issues that do not fall into one of the other reports in this category.
Incident Location Information
Please provide location information related to the incident.
Incident Location
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Please provide date and time information for which the incident occurred.
Beginning Timeframe
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Ending Timeframe
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Reporting Person Information
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First Name
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Middle Name
Last Name
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Date of Birth
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Racial/Ethnic Identity
Asian
Black, African, or African American
Hawaiian or Pacific Islander
Hispanic, Latino/a/x, or Caribbean
Middle-Easterner or Arab
Multiracial or Mixed
Native American or Indigenous
White or Caucasian
Another
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Gender/Gender Identity
Male
Female
Another Gender Identity
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Phone Number
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Email Address
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Confirm Email Address
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Home Address
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Zip Code
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Driver's License Number
Driver's License State
If you are reporting on behalf of someone else, please click Add Additional below and include the victim's information.
+ Add Additional : Reporting Person Information
Suspect Information
Please provide any known suspect information related to this incident, if any.
Race/Ethnicity
Asian
Black
Hispanic or Latino
American Indian/Alaskan Native
Native Hawaiian/Other Pacific Island
Unknown
White
Age
Gender
Male
Female
Unknown
Hair Color
Eye Color
Height
Weight
Clothing
Vehicle Description
Vehicle License Plate
Name
Date of Birth
Phone Number
Address
Other Info
Incident Narrative
Describe your incident here, and please be as detailed as possible.
Incident Narrative
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Reason for Reporting
What is your reason for reporting this incident?
Do you want to press charges, or are you reporting for insurance/informational purposes only?
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I want to Press Charges
I am reporting for Insurance/Informational Purposes Only
Supplemental Information
Please add any additional information regarding your initial report
Supplemental Information
Documents, Pictures or Videos
Please provide any Documents, Pictures or Videos to Support your Case
Filing a false police report is a crime (ORS 162.375). Please review your information above.
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500 Central Avenue
Coos Bay, OR 97420
Non-Emergency Phone: 541-269-8911
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