March Joint Powers Authority
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Green Acres Incident Report


Any incidents involving a crime should be reported directly to the local police. If possible, the report should be completed within 24 hours of the event.

If you wish to submit form in person, please bring it to the March Joint Powers Authority offices during regular business hours, or by using the 24/7 drop box located outside the office. Office address: 14205 Meridian Pkwy. Suite 140, Riverside, CA 92518. Forms may also be faxed to 951-653-5558.

Fields with ' * ' are required.
 
INFORMATION ABOUT PERSON SUBMITTING INCIDENT REPORT
(Person completing the report)
 
First Name*
Last Name*
Street Address*
City*
State*    Zip*    
Phone*
Email*
Identifier* Resident
Employee
Visitor
Vendor
Other   
 
INFORMATION ABOUT PERSON INVOLVED IN THE INCIDENT
First Name*
Last Name*
Street Address*
City*
State*    Zip*    
Phone*
Email
Identifier* Resident
Employee
Visitor
Vendor
Other   
 
INFORMATION ABOUT THE INCIDENT
Enter the date and time the incident occurred
Date* (MM/DD/YYYY)
Time* (HH:MM)     AM    PM
Location of the incident*
Were the police notified?* Yes    No
Which police department was notified? Riverside Police
Moreno Valley Police
Perris Police
Other   
 
Description of the incident.*
Please detail what happened, how it happened, factors leading to the event, etc. Be as specific as possible.
 
WITNESS INFORMATION
Were there any witnesses to the incident?* Yes    No
If yes, please list the full name of the witness.
Witness Phone
Was any individual injured?* Yes    No
If so, describe the injury (laceration, sprain, etc.), the part of the body injured, and any other information regarding the resulting injury/injuries.
Was medical treatment provided?* Yes    No
If medical treatment was provided, please select the type of treatment. On Site
Urgent Care
Emergency Room
Other   
 
ADDITIONAL INFORMATION
Please list any additional information.
 




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March Joint Powers Authority
14205 Meridian Parkway, Suite 140
Riverside, CA 92518
Office: 951-656-7000    Fax: 951-653-5558
Email: info@marchjpa.com

Office Hours:
Monday - Thursday: 8:00am - 5:00pm
Friday: 7:30am - 4:30pm
Saturday and Sunday: CLOSED
Engineering, Building and Safety, and Green Acres Showings by appointment only.




March Joint Powers Authority
14205 Meridian Parkway, Suite 140
Riverside, CA 92518
Office: 951-656-7000    Fax: 951-653-5558

Email: info@marchjpa.com

Office Hours:
Monday - Thursday: 8:00am - 5:00pm
Friday: 7:30am - 4:30pm
Saturday and Sunday: CLOSED
Engineering, Building and Safety, and Green Acres Showings by Appointment Only.