Skip to Main Content
Loading
Loading
Government
Departments
Business
Community
How Do I...?
Home
Form Center
Form Center
Search Forms:
Search Forms
Select a Category
All Categories
Administration and Board Forms
CED FORMS
EMA Forms
Human Resources Forms
Police Forms
Public Works Forms
Special Events Forms
Staff Contact Forms
Test
Utility Billing Department Forms
By
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Police Follow-up Form
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
THE INFORMATION YOU REQUEST (Check Applicable):
I wish to file a(an):
*
Update on Case
Suggestion
Inquiry
Other
You are:
*
Victim
Complainant (Employee of Victim)
Other:
Contact Information
Full Name
*
Date of Birth
*
Your Driver’s License/State Id (If available):
Email Address
Street Address:
*
Phone Number
*
Work Phone:
INCIDENT DETAILS:
Brief Description of Incidident or Request:
*
Location of Incident:
*
Date of Incident:
*
Time of Incident:
Name of Bensenville Officer/Employee(If known):
Name of Witness(es) or Others Involved (If known):
Witness Address (If known):
Witness Phone:
Statement/Description of Incident/Reason for Request/Additional Info. about Case:
*
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
Submit and Print
* indicates a required field
Bensenville Theatre
Board & Committee Meeting Schedule
Citizens Transparency Center
Completed FOIA Requests
Construction Updates / Maps
E-Services
Media & Updates
Village Code
Bensenville WebTV
Bensenville Weather Information
Arrow Left
Arrow Right
[]
Slideshow Left Arrow
Slideshow Right Arrow