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P O L I C E S U P P O R T R E Q U E S T

F O R M SPECIAL NOTE: Please be specific with the exact location(s) for the category you are filling in the form at the bottom. Thank you. Roosevelt K. Vonil, GCA President call GCA. P.S. Bring form to meeting, mail or

SPECIAL NOTE: You dont have to give your name or address. But you do have to identify the exact Home, Business, or Apart. Building location and any observations below in space provided. PLEASE PRINT ONLY N a m e ____________________________________________________________________________ A d d r e s s _________________________________________________Zip_____________________ P h o n e _____________________________________E m a i l __________________________________

SUSPECTED DRUG HOUSE, BUSINESS, OR APT.

SUSPECTED DRUG DEAL VICINITY NEAR HOME, BUSINESS OR APT.

Address Location

Address Location
*Non-maintained means garbage trash milling in areapotential fire hazard; rotting fence hazard; serious building hazard decline; depilated, unsafe garage; and last yearno snow removal because there are no occupants in home.

UNSECURED, VACANT OR FORECLOSED HOME FORECLOSED OR VACANT HOME: NONMAINTAINED*

OTHER INTEL FOR POLICE OF A CRIMINAL NATURE.

Address Location

Address Location
YOU MUST DESCRIBE FULLY ON BACK OF THIS SHEET.