Aquatic Center Theft/Lost Property Report

If while visiting the Clearfield Aquatic Center you have been the victim of a theft, or if you want to report lost property, please complete the following information. Your personal information is protected and will only be used for official police business.

Do not use this method for Emergencies or In-Progress Situations - for an emergency, please call 9-1-1. 

If you prefer, you can download the form and send it in by following the forwarding instructions on the form. 

Theft or Lost Property

Personal Information

First Name:   Last Name:   

Date of Birth:   

Street Address:  City:   State:   Zip Code: 

Home Phone:   Mobile Phone: 

Email: 

Theft/Lost Property Details and Property Descriptions

*Please Check Appropriate Box  My property was stolen   My property was lost or misplaced

Date of Theft or loss (If known):  

Description of lost of stolen property, inlcuding make, model, serial or account numbers, etc.

Item 1

Description:  

Make:   Model: 

Serial:   Account: 

Value: $


Item 2

Description:  

Make:   Model: 

Serial:   Account: 

Value: $


Item 3

Description:  

Make:   Model: 

Serial:   Account: 

Value: $


Item 4

Description:  

Make:   Model: 

Serial:   Account: 

Value: $


Item 5

Description:  

Make:   Model: 

Serial:   Account: 

Value: $


Item 6

Description:  

Make:   Model: 

Serial:   Account: 

Value: $

Please Describe where the property was taken or where it was lost?

If property was taken from locker, was it locked?  Yes  No

Do you have any suspect information?  Yes  No

If yes, please give names if known, or description of suspects:

Importation Information

After you have followed the reporting instructions and you have submitted your complaint to the police department, the police department will generate a police report with an assigned case number. If you have provided your email address the case number will be emailed to you.  A copy of the official report may be obtained by contacting the Clearfield Police Department Record's Division at 801-525-2812. 


*If in the future you obtain additional information that might lead to the recovery of your property or to the identification of suspects, i.e., unauthorized credit card use, etc., please contact the police department at 801-525-2806. 
In regards to this report and the information you have supplied for this report, you are notified that any false information you supply or false statements you make, and which you do not believe to be true, may subject you to criminal punishment as a class A misdemeanor. 


I have read this statement and admonition and the facts contained in this report are true and correct. 

 Agree   Disagree

 



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