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Financial Fraud Packet

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    This form is intended to be filled out by those that are using NBPD's Online Police Report system to file a financial crimes or fraud report. In order to help investigators with your case, please fill out the information accurately and completely using as much specific information as possible.
  3. Was your home address different at the time of the crime?
  4. Is the person listed above the victim of the financial crime?*
  5. Financial Fraud Questions*
    To the best of your knowledge, what type of crime has been committed against you? (Check all that apply)
  6. You selected Other from the previous list. Please describe the type of crime.
  7. Please include the date you first became aware of the crime, when the fraudulent activity began, and how you became aware of the crime. Please be as specific as possible.
  8. Supporting Documentation
    PLEASE NOTE: You will be asked to provide supporting documentation for each fraudulent act. This could include bank statements, copies of checks, copies of bills, copies of applications, proof of accounts from collection agencies, or copies of credit reports. This information can be uploaded to the actual police report using the Online Police Report system.
  9. Please list all credit cards, bank cards, checks, documents, or forms of identification that were stolen, obtained in your name, or fraudulently used. Be sure to include account numbers, ID numbers, check numbers, and other specific information.
  10. Compromised Documents or Information*
    To help assist us with determining how your information may have been compromised, please check any of the following that may be applicable:
  11. You indicated that you gave your password or PIN to someone else. Please give us their name and any contact information (ex: phone number) that you have for them.
  12. You indicated that service or cleaning vendors were in your home. Please provide us with the name and contact information (ex: phone numbers) for each vendor that was in your home when you believe your information was compromised.
  13. You indicated that your incoming or outgoing mail was stolen. Please give us the date range when your mail was stolen.
  14. You indicated that your information may have been compromised in a way that was not listed here. Please tell us how you believe your information was compromised.
  15. Do you have information about a possible suspect?
  16. Suspect Gender
  17. Are there any witnesses to this crime?
  18. Please provide the full name and contact information for each witness.
  19. I have previously reported this crime to another law enforcement agency.*
  20. Please provide the name of the law enforcement agency, the name of the person that took the report, their contact phone number, and a case number or report number.
  21. Did you authorize anyone to use your name or personal information to seek employment, money, credit, loans, goods, or services?*
  22. Did you receive any benefit, money, goods, or services as a result of the crime committed against you?*
  23. I am willing to assist in the prosecution of the person(s) who committed this crime against me, even if the suspect is related or known to me.*
  24. I authorize the release of any information to law enforcement for the purpose of assisting in the investigation and prosecution of the person(s) who committed this fraud.*
  25. Please provide us with any additional information that may be helpful in the investigation of your financial crime.
  26. Additional Information May Be Needed
    PLEASE NOTE: This form is designed to give investigators a preliminary look at the crime you are reporting. Additional information, including detailed financial records, bank statements, and copies of documents like checks, bills, applications, and/or credit reports may be required.
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  28. This field is not part of the form submission.