Form Ucr-28 - Cargo Theft Incident Report Page 2
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6OMB 1110-0048
(Rev. 02-08-2012)
Expires 12-31-2015
Property Information
Stolen Property Description
Stolen Value
Property
Date
Recovered Value
Recovered
Recovered
Offender Information
(“00” if Unknown)
Race
Ethnic Origin
Native
Sex
Black or
American
Age
Hawaiian or
Hispanic
Non-Hispanic
White
African
Indian or
Asian
Unknown
(01-99)
Other Pacific
or Latino
or Non-Latino
M
F
U
American
Alaska Native
Islander
Arrestee Information
Race
Ethnic Origin
Native
Sex
Black or
American
Age
Hawaiian or
Hispanic
Non-Hispanic
White
African
Indian or
Asian
Unknown
(01-99)
Other Pacific
or Latino
or Non-Latino
M
F
American
Alaska Native
Islander
This report is authorized by Public Law 109-177 (HR 3199), March 9, 2006, under the USA Patriot Improvement and Reauthorization Act of 2005. Even though you are not
required to respond, your cooperation in using this form to report Cargo Thefts will assist the FBI in reporting the economic impact of Cargo Theft on the U.S. economy. Please
submit completed reports to: UCRstat@leo.gov. Questions may be submitted to: Federal Bureau of Investigation, Criminal Justice Information Services Division, Attention:
Uniform Crime Reports/Module E-3, 1000 Custer Hollow Road, Clarksburg, West Virginia 26306; telephone 304-625-4830, facsimile 304-625-3566. Under the Paperwork
Reduction Act, you are not required to complete this form unless it contains a valid OMB control number. The form takes approximately 5 minutes to complete. Instructions for
preparing the form appear on the following page(s).
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