Yuma PD Report Fireworks Form

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Date of Entry*
MM slash DD slash YYYY
What type of activity are you reporting?*
- Use of illegal fireworks
- Sale of illegal fireworks
Do you know the address of the fireworks activity?*
- Yes
- No
Enter address of fireworks activity:
Street Address City
Enter cross streets of fireworks activity:
Cross Street 1 Cross Street 2 City
Additional comments:
Upload screenshots/images of illegal fireworks advertisement(s) here:
Drop files here or

Max. file size: 128 MB, Max. files: 5.
Enter your email:
*Optional
Comments
This field is for validation purposes and should be left unchanged.