MISSING PERSONS REPORT Berwick Police Department Berwick High School 1100 Fowler Avenue Berwick, Pennsylvania 18603

MISSING PERSON Name: Alias/Street Relatives: Name/Nickname:

Race:

Height:

Weight:

Hair:

Eyes:

Sex:

Hat:

Jacket/Coat:

Shirt:

Pants:

Skirt/Dress: Shoes:

Age:

DOB:

Social Security #: Scars/Marks/Tattoos: XXX-XX-XXXX

Overall Health:

Last Seen Health Condition:

Last Seen By:

Last Seen Location:

Last Seen Date:

Last Seen Time: Approx.

Address:

Residence Phone: N/A Business Phone: N/A

Occupation:

Employer/School:

Employer Address:

MISSING PERSON REPORTED BY Name: Address: Residence Phone: Business Phone:

REPORTING PERSONS NARRATIVE (Brief narrative of the facts surrounding the missing person
report.)

REPORTING OFFICER REPORTING OFFICER SUPERVISING OFFICER

// Signature

DATE REPORTED
Unit Number 00/00/00 Date 00/00/00 Date

Signature

Unit Number