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Defrauding an Innkeeper (Updated 2015-02)
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On-Line Crime Reporting - Defrauding an Innkeeper
Use this form to make a report to law enforcment about an incident in which a person attempted or intended to defraud, obtain food, lodging or other accomodations from a business. (NCGS 14-110). Please provide as much complete information as possible, including contact information in the event that there are questions concerning your report.
I am the (select one)
*
Victim
Witness
Third party
First Name
*
Last Name
*
Address1
*
Address2
City
*
State
*
Zip
*
Phone Number including area code:
*
Email
If you are a third party reporting a crime, please state who you are reporting for:
First Name
Last Name
Address1
Address2
City
State
Zip
Location of Incident/Crime:
Common name of place if applicable (ie: Holiday Inn, Home Suites, etc.):
Address1
Address2
City
State
Zip
Date and Time Incident occurred
*
Date and Time Incident occurred Start Date
Date and Time Incident occurred Start Time
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Date and Time Incident occurred End Date
Date and Time Incident occurred End Time
Description of Incident
Description of suspect
Enter here any description you can provide of the suspect (ie: height, weight, race, clothing, age, sex, unusual markings such as tattoos or scars, etc) If known, include name of suspect.
Damages due to Incident
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