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2. To report illegal drug activity within Montgomery County, please complete the following boxes.
   All information is kept strictly confidential.
4. Suspect names (include aliases)
5. Suspect Address
7. Please describe the illegal drug activity
9. Location of drug activity
11. Suspect vehicles (Make, Model, Color, License plate #)
13. How do you know drugs are sold (by the suspect or at the location)?
15. Does the suspect(s) carry firearms?
17. Reporting party contact information below is optional. All information, including your contact information, is kept strictly confidential.
19. First Name
20. Last Name
22. Address1
24. Address2
26. City
27. State
28. Zip
30. Home, Work or Cell Number
31. May a drug Investigator call you confidentially to discuss your complaint?

    1. Yes
    2. No
32. If Yes, when is the best time to call?
34. Email address
35. May a drug Investigator email you for more detailed information?

    1. Yes
    2. No
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field