COMPLAINANT/VICTIM NAME:
REPORT No. (IF Known):
LOCATION OF INCIDENT:
DATE INCIDENT WAS REPORTED:
TYPE OF INCIDENT:
POLICE OFFICER, IF KNOWN:
Date:
Note: CRIME REPORTS ARE RELEASED ONLY TO THE FOLLOWING:
1
COMPLAINANT
2
REPORTING PERSON
3
VICTIM
4
OWNER OF PROPERTY
NUMBER OF COPIES NEEDED:
PURPOSE OF THIS REQUEST:
SIGNATURE:
DATE REQUESTED:
DATE VERIFIED BY:
PAID
NOT PAID
 Please PRINT all information clearly and legibly and make sure that all information is correct
VIPD-PR-2022
1A-COPY FEE ($10.00)
THANK YOU FOR YOUR COOPERATION
      IDENTIFICATION
IS              
REQUIRED
Signature of Applicant (Requesting this record check)
U.S VIRGIN ISLANDS POLICE DEPARTMENT
 POLICE REPORT REQUEST
            LAST
         FIRST
       MIDDLE
stxvipdrecordsrequest@usvi.onmicrosoft.com  – STX 
sttvipdrecordsrequest@usvi.onmicrosoft.com  – STT/STJ 
On completion of this form, please email to: 
Records Bureau, VIPD  
SIGN
SIGN