Get NY PD 542-061 2006-2024

This Form is 8 X 14 Submit Two Copies of This Form VERIFICATION OF CRIME/ LOST PROPERTY PD 542-061 Rev. 09-06 Complainant/Victims will be sent veri cation free of charge other applicants must send a non-refundable processing fee of 15. 00 Check or Money Order NO CASH payable to the NYC Police Department with each application* All applicants must enclose a stamped self-addressed envelope. Please mail requests to New York City Police Department Criminal Records Section Veri cation Unit 1 Police Plaza Room 300 New York NY 10038. Complaint Number Precinct of Report FOR USE BY CRIMINAL RECORDS SECTION Mail Record To Print or Type Applicant s File No* 1. Exact location where crime / loss took place 2. Date reported to Police Precinct of Occurrence Time if known This report Crime concerns Other describe Lost Property 3. Full name and address of complainant/victim as reported to Police Department Date and Time of Crime / DATE TIME Name of of cer who received your report if known* than date of report Any additional information which may aid in searching for your record INSTRUCTIONS In order to nd this record you MUST furnish all information requested above particularly the complaint number and precinct of record Occurrence. Veri cation of your request cannot be made without this information* The complaint number may be obtained by calling the precinct or detective squad concerned during the hours of 9 a*m* to 5 p*m* Submit Two Copies of This Form* Applicant s Signature Date Name and address of insurance company FOR POLICE DEPARTMENT USE ONLY FOLLOWING IS A VERIFICATION OF THE ABOVE REQUEST MOTOR VEHICLES CURRENCY JEWELRY FURS CLOTHING FIREARMS OFFICE EQUIPMENT T. V. RADIOS CAMERAS ETC. HOUSEHOLD GOODS CONSUMABLE GOODS MISCELLANEOUS BRIEFLY DESCRIBE MANNER OF CRIME / LOSS OF PROPERTY Alarm No* Report veri ed by print title name/sign. 00 Check or Money Order NO CASH payable to the NYC Police Department with each application* All applicants must enclose a stamped self-addressed envelope. Please mail requests to New York City Police Department Criminal Records Section Veri cation Unit 1 Police Plaza Room 300 New York NY 10038. Please mail requests to New York City Police Department Criminal Records Section Veri cation Unit 1 Police Plaza Room 300 New York NY 10038. Complaint Number Precinct of Report FOR USE BY CRIMINAL RECORDS SECTION Mail Record To Print or Type Applicant s File No* 1. Complaint Number Precinct of Report FOR USE BY CRIMINAL RECORDS SECTION Mail Record To Print or Type Applicant s File No* 1. Exact location where crime / loss took place 2. Date reported to Police Precinct of Occurrence Time if known This report Crime concerns Other describe Lost Property 3. Exact location where crime / loss took place 2. Date reported to Police Precinct of Occurrence Time if known This report Crime concerns Other describe Lost Property 3. Full name and address of complainant/victim as reported to Police Department Date and Time of Crime / DATE TIME Name of of cer who received your report if known* than date of report Any additional information which may aid in searching for your record INSTRUCTIONS In order to nd this record you MUST furnish all information requested above particularly the complaint number and precinct of record Occurrence. .