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This tool has been put in place to allow the secure uploading of large and potentially sensitive/confidential files. After the upload has been completed, the files will be encrypted and can be accessed by the relevant Police Force.

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Dashcam Submission Form

In accordance with the Criminal Procedure Rules, r 16; Criminal Justice Act 1967, s. 9; Magistrates’ Courts Act 1980, s.5B

This statement which is signed by me is true to the best of my knowledge and belief and I make it knowing that, if it is tendered in evidence, I shall be liable to prosecution if I have wilfully stated in it, anything which I know to be false, or do not believe to be true.

By typing your name below you are signing this document electronically. In doing so, you certify that this forms your electronic signature as provided under section 7 Electronic Communications Act 2000.

One statement is required for each submission/offending vehicle. We are unable to process multiple offences sent as one submission.

Signature box:

Today's date:

Your Details

Your first name:

Your last name:

Your email address:

Your phone number:

Your preferred means of contact:

Your home address:

Your current occupation:

Your Age (in years):

Date of birth:

Place of birth:

Former or maiden name(s):

Gender:

Dates you will be unavailable over next 6 months (e.g. foreign holiday):

0/2000

Incident Details

In your own words, briefly describe what happened:

Location of incident:

Where were you exactly when the incident happened:

Where were you travelling towards:

Date of incident:

Day of incident:

Time of Incident (24h clock format):

Offending Vehicle Reg:

Offending Vehicle Colour:

Vehicle Make:

Vehicle Model:

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PLEASE DO NOT UPLOAD FILES NAMED WITH INSULTING WORDS, WE WILL NOT BE ABLE TO PROCESS THEM.

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Dashcam Submission Form

Your Details

Incident Details

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