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Forged Check(s)
Reporting Person Information
Please enter your information.
First Name (required)
Middle Name
Last Name (required)
Date of Birth (required)
Racial/Ethnic Identity
Gender/Gender Identity
Phone Number (required)
Email Address (required)
Confirm Email Address (required)
Home Address (required)
Zip Code (required)
Driver's License Number
Driver's License State
If you are reporting on behalf of someone else, please click Add Additional below and include the victim's information.
Incident Location Information
Please provide location information related to the incident.
Incident Location (required)
Please provide date and time information for which the incident occurred.
Beginning Timeframe (required)
Ending Timeframe (required)
Forgery - Forged Check
Please provide information related to the forged check(s) involved in this incident.
Issued By
Issued To
Amount (required)
Check Number
Date Cashed (required)
Location Cashed (required)
Mobile Deposit
Please include an image of the check below in the Attachments Section. If you are unable to upload an image of the check, please describe the check and how it was altered in your narrative.
Suspect Information
Please provide any known suspect information related to this incident, if any.
Hair Color
Eye Color
Vehicle Description
Vehicle License Plate
Date of Birth
Phone Number
Other Info
Hate/Bias Information
Please provide information related to the Hate/Bias Crime you feel in this incident, if any.
Do you feel this is a hate/bias crime? (required)
If yes, please select why you feel targeted.
If yes, please explain in your narrative of events on why you feel this is a hate/bias crime.
Incident Narrative
Describe your incident here, and please be as detailed as possible.
Incident Narrative (required)
Documents, Pictures or Videos
Please provide any Documents, Pictures or Videos to Support your Case
Appointment Contact Information
Please provide the best e-mail and phone number to reach you for this appointment.
E-Mail Address (required)
Mobile Phone Number (required)
Please Select Appointment Type: Phone Call, Zoom Meeting, or No Appointment (required)
Schedule Contact Appointment
Please pick an available date and time for an officer to contact you via Phone or Zoom.

Filing a false police report is a crime (ORS 162.375). Please review your information above.

300 Country Club Road
Eugene, OR 97401
Phone: 541-682-5111
Fax: 541-682-6804
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