Newbury Police Department
25 High Road, Newbury Massachusetts 01951
newburypolicedept.com
Report Request/Submission Form
Your name:
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Your E-mail Address:
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Your Agency (if applicable)
Your complete address:
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Your phone number:
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Alternate phone number:
Best time to contact you?
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AM
PM
Date of incident (approximate is acceptable)
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Type of report:
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Theft Related Investigation
Arrest Related Investigation
Restraining Order/Domestc Abuse Related
Other (specify in notes)
Principal Party Name:
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Principal Party Date of Birth:
Your involvement in this investigation:
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Victim/Complainant
Vehicle Operator or Owner
Probations/Parole
Defense Attorney
Department of Social Servies
Witness
Involved Participant
Suspect
Arrestee
Insurance Agency
Press
Other (specify in notes)
Investigating officer:
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Chief Michael Reilly
Deputy Chief John Lucey
Sergeant Jay Routhier
Sergeant Patty Fisher
Detective Aaron Wojtkowski
Officer Greg Frappier
Officer Stephen Jenkins
Officer Mark Smigielski
Officer Michael Croteau
Officer Michael Nary
Officer Stephen Smith
Officer John Lucey III
Officer James Velonis
Officer Michael Mailhot
Officer John Regan
Officer Andrew Bridges
Officer Joseph Santiago
Dispatcher Sallie Zinck
Dispatcher Dan Jenkins
Not Applicable
Not listed
Not sure (officer did respond)
No police response
Other (explain in notes)
Attach an associated file:
How would you like your report delivered?
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Email (preferred)
Postal Delivery
FAX (enter FAX number in notes field)
Not Applicable (you are the sender of a file)
Notes:
Verification Code
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Enter Verification Code
:
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Required
