Online Anonymous Sexual Assault Report

This form was designed to facilitate the anonymous report of a sexual assault. Such reports help the Lincoln Police Department understand the current sexual violence trends in our city and can serve to introduce the reporting party to the criminal justice system in Lincoln. Filing this form will not result in an investigation unless the victim later decides to make a formal report to law enforcement. The completion of this form is also the first step, should the victim decide to have a forensic exam completed at a local hospital.


Assault Information


Date of Assault Time

Place of Occurrence
An address is preferred, but if it occurred at the victim's home, a team area, part of town or street, coordinates are acceptable.


Suspect Information


Name/Nickname Age

Address

Physical Description/Distinguishing Characteristics
Include odors, scars, tattoos, facial hair, speech impediments, etc.


Suspect/Victim Relationship


Partner/Lover
Ex-Partner/Lover
Spouse
Colleague/Co-Worker
Acquaintance
Met Same Day-Socially
Met Same Day-NonSocially
Stranger

Type of Coercion/Force


Verbal
Physical
Threat of Death
Presence of a Weapon Yes No
If Yes, what type
Incapacitation by Drugs or Alcohol Yes No
If Yes, what type
Other Coercion/Force

Were You physically injured? Yes No
(If yes, please describe the extent and nature of your injuries in detail.)



Nature of the Assault


Attempted
Completed
Vaginal
Oral
Anal

Place of Occurrence


Victim's Home
Suspect's Home
Unknown Home
Hike/Bike Trail
Car/Vehicle
Workplace
Park
Outdoors
Parking Lot
Other

Manner of initial contact

(Came to victim's door, attacked on street, etc.)


What did the suspect say before, during and after the assault?

(Please be as specific as possible)


Do you plan to make a formal report to the police?

Yes No Not Sure

If not yes, why have you chosen to make an anonymous report
rather than make a formal report to the police?


Please give a narrative of the sexual assault

(Please provide as much detailed information as possible)





If your browser does not support forms, please complete the print-out form and mail to:
Lincoln Police Department
Crime Analysis Unit
575 South 10th Street
Lincoln, Nebraska 68508