KCSO ORC Unit — Incident Report

Complainant Information Person Reporting the Incident

Full Name *

Title / Role

Date of Birth *

Contact Phone * (Not Store Number)

Contact Email *

Driver's License # *

DL State *

JIMS IDN (IF UNKNOWN, THE UNIT CAN LOCATE)

Subpoena Address * — Mailing address where you wish any subpoena to be sent

Vehicle Information Associated Vehicle (if observed)

Make (if known)

Model (if known)

Year (if known)

Color (if known)

License Plate (if known)

State (if known)

Direction of Travel (if known)

Other Descriptors (if known)

Evidence & Images Photos, CCTV Stills, Documents — Do not attach video files. Still images only.

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Click to upload or drag & drop files here
Photos and still images will be embedded into the PDF. Documents and office files will be listed in the PDF as supporting attachments.
Accepted examples: CCTV stills, photos, receipts, ID scans, merchandise lists, PDFs, Word documents, and spreadsheets. Video files are not allowed.

Attestation & Acknowledgment

I, the undersigned, hereby submit this report to the Knox County Sheriff's Office Organized Retail Crime Unit, a law enforcement agency. I attest and affirm that:

The information contained in this report is true, accurate, and complete to the best of my knowledge and belief. I understand that this report constitutes an official statement made to law enforcement, and that knowingly providing false, misleading, or fabricated information in this report is a criminal offense and may be considered perjury or filing a false police report under applicable Tennessee law, and may subject me to criminal prosecution.

I further understand that the information contained in this report will be included in the official case file, which will be submitted to the District Attorney's Office for review and prosecution.

I understand and affirm that the information in this report is accurate to the best of my knowledge, and I acknowledge that submitting false information to law enforcement may constitute perjury.

Submission Notice This report will generate a PDF and download it directly to the user's device before prompting them to email it to the Knox County Sheriff's Office Organized Retail Crime Unit.
All information is treated as confidential law enforcement data.
Ensure all required fields (*) are complete before submitting.

Report Generated