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  Department     ex. Hometown Police Department
  Acronym     ex. HPD
  Country   
   
  Postal Code     ex. 95304
  Email address     ex. itmanager@hometownpd.org
  Reports     (per month)
      Note: Indicate how many reports per month you currently take in the following categories:
Harassing Phone Calls, Lost Property, Theft, Vandalism, Vehicle Burglary, Vehicle Tampering
  Report cost    $   (current cost to take one of these reports)
  IP address     (Your IP address is recorded for security purposes)