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Incident Information
Enter the date and approximate time the reckless driving happened.
Enter the location where you saw the reckless driving.
Upload the video of the reckless driving.
Enter your information.
Enter name of person who witnessed the reckless driving and is willing to testify.
Provide information regarding the reckless driver.
Do you know the identity of the driver?
What is the gender of the person?
Enter the approximate age of the person.
What type of clothing were they wearing?
Enter race of the person.
Enter hair color of person.
Provide any other distinguishing features of the person.
Describe anything else the driver did that was not captured on the video or in pictures.
Enter make of vehicle.
Enter model of vehicle.
Enter license plate including state.
Provide any other information about the vehicle.
If a person is charged with an offense as a result of this video, I am willing to testify in court about what I saw.
This field is not part of the form submission.
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