Form Center

2. CALL 9-1-1 for EMERGENCIES
4. OFFENSE TYPE: Choose from the crimes listed here.*
   -- Select One --Identity TheftPackage Theft (i.e. from a delivery)Credit Card AbuseCriminal MischiefIllegal DumpingHarassing Phone CallsHarassmentFraudForgeryTheft from an AutomobileTheft of Automotive PartsTheft from a Person (NOT a Robbery, which includes the element of force or intimidationTheft from Coin Operated MachineTheft from DETACHED GarageTheft from Building (NOT a Habitation/Home)-------------END--------------

   Only crimes listed here and under $5000 can be initiated online. For all other other concerns, please call us at 713-668-0487.
5. Date of Crime
   Date of Crime
6. Probable Time of Crime
   Probable Time of Crime
8. Address of Crime

   Address MUST be within Bellaire City Limits (77401)

10. EXPECT A CALL BACK FROM THE BELLAIRE POLICE DEPARTMENT
    This online information is a screening tool. Following submission, an officer will be calling you back.
12. IMPORTANT INFORMATION YOU MUST READ

    The incident must have occurred in the City of Bellaire, Texas 77401. The person reporting must be 18 years of age or older. The reported crime must not be a "bias" motivated crime. Concerns regarding firearms, explosives and other material that threaten public safety cannot be reported online. Crimes with tangible evidence such as possible fingerprints, photographs, witnesses or video cannot be reported online. Crimes such as Burglary of a Habitation/Home, Assault, Automobile Theft, Robbery, Crimes in Progress or those involving property valued over $5000.00 as well as requests for information, must be called into the Bellaire Police Department at 713-668-0487.

14. REPORTEE INFORMATION
16. First Name*
    First Name
17. Last Name*
    Last Name
18. Gender

    1. Male
    2. Female
19. Race/Ethnicity
    -- Select One --WhiteBlackHispanicAsianAmerican Indian/Alaskan NativeHawaiian or Other Pacific IslanderUnknown/Prefer not to disclose
21. Date of Birth
    Date of Birth
22. Person or Business*

    1. Person
    2. Business
23. Business Name
25. Best Phone Number*
26. Email*
27. Bellaire Resident?

    1. Yes
    2. No
29. Street Number
30. Street Name
31. Street Type
32. Apt #
34. City
35. State
36. Zip
40. OFFENSE DETAILS FOR PROPERTY CRIMES
    For crimes involving TANGIBLE PROPERTY please provide a brief description of the items taken or damaged such as make, model, color, material, size, weight, etc, and provide an estimated value of the item or damage.
42. Item taken or damaged 1
43. Estimated value
45. Item taken or damaged 2
46. Estimated value
48. Item taken or damaged 3
49. Estimated value
51. Item taken or damaged 4
    For items over four (4) that were taken or damaged, please include in Narrative Section
52. Estimated value
56. Narrative: Please provide a brief explanation of what happened and relevant details of the crime.*
    Please try to answer the Who, What, Where, Why, When and How.
58. "Signature"*
    Please type your full name to act as your signature and verification the provided information is accurate. Please be aware providing false or misleading information to the police can be a crime.
60. 
Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit

* indicates a required field