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2. Disclaimer

   “WARNING: If you are seeking to obtain an official police report regarding a crime, please contact the police department’s main line at 603-432-1118 and request to speak with an officer.”

4. 
5. First Name*
6. Last Name*
8. Date of Birth*
9. Primary Contact Number*
10. Address*
12. City*
13. State*
14. Email Address
16. Select which Officer to send this to
    -- Select One --Officer AikawaOfficer AkuOfficer AlfaroOfficer AllaireConservation Officer AprileSergeant ArchambaultOfficer ArelSergeant BalukonisOfficer BartoliniOfficer BenoitSergeant BukerAnimal Control Officer CarverSergeant CruzOfficer DeFeliceOfficer DelforteSergeant DuguayOfficer Emily DyerOfficer Randy DyerDetective FordSergeant FredaDetective GarciaOfficer GauthierOfficer GoodnowTrevor GuaySergeant HallockOfficer JaneczkoSergeant LeeOfficer MacLeanOfficer MarcianoOfficer MartinSergeant MalloyOfficer MoralesSergeant MoranK9 Officer MorinOfficer MottramOfficer MuellerSergeant OlsonOfficer Dan PerryOfficer John PerryOfficer PhanDetective PhillipsOfficer ReitzeK9 Officer RibeiroOfficer SabellaOfficer SlackOfficer SmigelskiOfficer TufoOfficer VerrierOfficer Wiggin
18. Statement
20. Upload a photograph or document
22. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, 3) you may still be required to provide a traditional signature at a later date, and 4) you swear the statement above is truthful and know false statements can be punishable by law.

    1. I swear and agree
24. Electronic Signature
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field