Bad Check Crime Report Form

 A “YES” answer to any of the questions indicates this is a CIVIL matter, and is therefore ineligible for filing with the Cripple Creek Police Department. Please contact the nearest small claims court for instructions on how to proceed with a civil case. If all boxes were checked “NO,” please complete this report, date and sign it, and forward to the above address. PRIOR TO SUBMISSION, A “COURTESY NOTICE” SHOULD BE SENT TO THE CHECK WRITER. (See sample notice below.)

Was check post-dated at time of acceptance?
Does this matter involve a two-party check?
Was check received as payment on an account?
Were you asked to hold or delay depositing the check(s)?
Does the check involve an extension of credit?
One file only.
256 MB limit.
Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods.

Suspect

How did you obtain the check writer’s identification?
Do you need notification that this crime report has been accepted into the program?
If so, please indicate how you would prefer to be notified.

Checks

Can person ID check writer

VICTIM (person filing)

I HAVE READ ALL FILING INSTRUCTIONS, AND HEREBY CERTIFY UNDER PENALTY OF PERJURY, THAT ALL INFORMATION IN THIS REPORT IS TRUE TO THE BEST OF MY KNOWLEDGE.
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