Date: [Insert Date]
Time: [Insert Time]
Location: [Insert Location]
Victim Name: [Insert Name]
Contact Information: [Insert Contact Information]
Statement:
[Provide a detailed account of the incident from the victim’s perspective. Include any specific details about the crime, suspect, and impact on the victim.]
Follow-Up Needed:
[Outline any additional steps required to assist the victim or gather further information.]
Officer Name: [Insert Your Name]
Badge Number: [Insert Your Badge Number]