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Energy Theft Reporting Form

Please correct the field(s) marked in red below:

1
Please provide as much information as possible. If certain lines won't accommodate your responses, please use the "Additional Comments" section at the bottom of the form.
Date:
2
Your Information
Name:
Address:
Contact Number:
E-mail Address:
3
Do you wish the above contact information remain confidential?
Do you wish the above contact information remain confidential?
4
Type of Theft or Tampering Observed (select all that apply):
Type of Theft or Tampering Observed (select all that apply):
Metal Theft
Electric Meter Tampering
Damaged IID Equipment
Damage to a Power Pole
Damage to Overhead Wiring
Damage to Overhead Wiring
5
Other:
6
Select the type of location where theft or tampering occurred:
Select the type of location where theft or tampering occurred:
IID Facility
IID Substation
Private Residence
Commercial Property or Business
7
Address or specific location of theft or tampering:
8

Closest street or landmark:

9
What date did you observe the theft or tampering activity?
10
What time did you observe the theft or tampering activity?
What time did you observe the theft or tampering activity?
11
Did you know the name(s) of the person(s) involved?
Did you know the name(s) of the person(s) involved?
12
Can you describe the person(s) involved?
Can you describe the person(s) involved?
13
Can you describe the vehicle(s) involved?
Can you describe the vehicle(s) involved?
14
If you answered "Yes" to the above question, please provide any or all of the following information:
Vehicle Make
Vehicle Model
Vehicle Year
Vehicle Style (pickup, sedan, SUV, tractor, etc.)
Vehicle Color
License Plate State
License Plate Number
15

Additional Comments:

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