| NAME (LAST, FIRST, M.I.) | AGE | SEX | HOME ADDRESS | NATURE OF INJURY | | :--- | :--- | :--- | :--- | :--- | | [Name of Injured 1] | [Age] | [M/F] | [Address] | [Description] | | [Name of Injured 2] | [Age] | [M/F] | [Address] | [Description] | | [Name of Injured 3] | [Age] | [M/F] | [Address] | [Description] |
| OPERATOR | SECTION OF LAW | DESCRIPTION | | :--- | :--- | :--- | | [Name] | [VTL Code] | [Violation Description] | uf 49 format nypd template
| INCIDENT DETAILS | DATE OF OCC: __________ TIME OF OCC: ________ TIME REPORTED: ________ OFFENSE / COMPLAINT TYPE (Code): ___________ (e.g., Harassment – 240.26) | NAME (LAST, FIRST, M
(Attach separate sheet if necessary)
The rank, name, and command of the person preparing the report. | NAME (LAST
Incidents should be documented in the order they occurred, using military time (e.g., 1426 hours).