Community Road Safety Watch Form (html)


 

COMMUNITY ROAD SAFETY WATCH

FOR OUR PUBLIC  ROADS

Community Road Safety Watch is your chance to help reduce irresponsible
drivers’ repetitive speeding and reckless driving in the future.

Once the required information is filled in below do one of the following:

  1. Mail report to the Hawaii Police Department
  2. Drop it off at the Hawaii Police Department
  3. Call in the report to Traffic Services: 808: 961-2226
  4. Fax report to Traffic Services: 808: 961-2228
  5. Email report to Traffic Services: Torey.Keltner@hawaiicounty.gov

MAHALO FOR YOUR CONTRIBUTION
TO THE SAFETY OF OUR PUBLIC ROADS

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _(fold in and tape)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

DO NOT FILL THIS OUT WHILE DRIVING!

*Date of Event: _____________________ *Time of Event: ___________________

*Vehicle License No.:________________ Violator: Male: _____ Female: _____
Make: _________ Color: ____________

*Location of Violation: ___________________________________________________
______________________________________________________________________

*Description of Violation: ________________________________________________
______________________________________________________________________

Reporter Name: _______________________________ Phone: ___________________

* Required Information                                                                                                        revised 05/13/05

 

 


_______________________________

_______________________________                                                                                              [Stamp]

_______________________________

 

 

Hawaii Police Department
Traffic Services Section
349 Kapiolani St.
Hilo, HI 96720

 

 

Please do not staple, tape here.