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2. DISCLAIMER

   THIS FORM IS NOT MONITORED 24/7.  IF YOU ARE TRYING TO REPORT A CRIME, CALL 402-593-4111.  IF THIS IS AN EMERGENCY, CALL 911.

3. Email Address*
5. Name*
6. Address
8. City
9. State
10. Zip Code
12. Phone Number
14. Select all that apply to your request.*

    1. Traffic Complaint
    2. Submit a Tip
    3. Recognize an Employee
    4. Project Lifesaver
    5. Contact a Chaplain
    6. Other
16. Information / Comments*
    Please explain any details or information to go along with your request.
18. Do you wish to be contacted back about your request?*

    1. Yes
    2. No

    Please select "Yes" if you wish to be contacted by a member of the Sarpy County Sheriff's Office about your request.
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20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field