You are here: Home » Police Stop FormPolice Stop Form Police Harassment Stop If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Email Phone * Your name (Road name is fine) * City where incident occurred * Date of Incident * Location of incident * Police Stop: Police Dept, Officer Name, Patrol Car# as much info as possible.. Police Stop: Reason given for Stop Police Stop: Please provide any other info you believe is important.. What is 2 + 9 *