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National Network of Fusion Centers
Suspicious Activity Report
For Private Sector / Corporate Partners Use

Important: If this is an emergency - Call 911.

Submitter's First Name:*

Submitter's Last Name:*

Company / Organization Name:*

Best Contact Number: (###) ###-#### *

Email Address: *


Incident Date *
  Time:    (e.g. 10 pm) 

Description of Activity (Help): *
 Breach/Attempted Intrusion
 Misrepresentation
 Theft/Loss/Diversion
 Sabotage/Tampering/ Vandalism
 Cyber Attack
 Expressed or Implied Threat
 Aviation Activity
 Eliciting Information
 Testing or Probing of Security
 Recruiting
 Photography
 Observation/Surveillance
 Materials Acquisition/Storage
 Acquisition of Expertise
 Weapons Discovery
 Sector-Specific Incident
 Officer Safety
 Human Trafficking
Other (describe below)


Prior Tip Tracking Number(s) (if applicable)

Name of Subject(s): (If available)  


Brief summary: *

Incident Location - Street Address or Cross Streets:

City:*
 

State:*


Please attach reports and/or photos:







Optional Information

Secondary Contact Name: (if applicable)

Alternate Contact Number: (###) ###-####  (if applicable)

Alternate Email Address: (if applicable)

 


Providing false or misleading information is a violation of Federal Law and may be subject to prosecution under Title 18 USC 1001.
All information is subject to review and verification.