HomeMy WebLinkAboutFillable form that victim of agricultural theft- ADA CompliantHawai’i County
Agriculture Theft/Trespass Self-Reporting Form Instructions
Theft of agricultural crops, livestock, equipment, chemicals, fertilizers, materials and supplies severely
impacts the livelihood of the local producers we depend on to provide jobs and food for our County.
Unfortunately, the incidences of trespassing and theft are under-reported. This lack of statistical data
reduces the legislative urgency for financial support to increase staffing and investment in anti-theft
equipment that the police need to curb these invisible criminal activities.
The Department of Research and Development, in collaboration with the Hawai‘i Police Department
and the Office of the Prosecuting Attorney, has produced a fillable form that a victim of agricultural
theft/trespass can prepare and leave for the responding officer.
Pro-Active Steps to Take BEFORE a Criminal Activity Occurs
1. Go to https://www.rd.hawaiicounty.gov
Click on Agriculture and Food Systems, then click on Information for Producers and there will be a
link to access the Agricultural Theft and Trespass Reporting Form. Download the PDF form.
2. Fill in the information about yourself and the farm; save this information on your computer.
3. Or print the form and hand print the information.
4. Prepare a map of your farm and storage area with the address; show the fencing, locations of
“No Trespassing” signs, buildings, and the different crops.
If a Criminal Activity has Already Occurred
1. Call the Police Department’s non-emergency number, (808) 935-3311, to report the incident.
2. Completely fill out the report form, print the map, and indicate the location of the trespass and
where the theft occurred.
3. You can wait at the crime scene and hand the report to the responding officer, who may have
additional questions for you.
4. If you need to leave the crime scene, call the dispatcher, and give your phone number and the
location where the report can be found.
5. Or if you need to leave the crime scene and will be passing by the Police Station in the district
where the theft/trespass occurred, you can drop the report off at the corresponding Police Station.
Link to the Hawaii Police Dept. (click on “Police Station Locations” in upper right-hand corner):
https://www.hawaiipolice.gov
If you Encounter a Trespasser(s) or a Theft in Progress
1. DO NOT attempt to confront the suspect(s).
2. Call 9-1-1, the emergency number.
Hawai’i County
Agriculture Theft/Trespass Self-Reporting Form
Reporter’s Information
Name:
Date of Birth: Last 4 SSN:
Address:
Phone:
Farm Owner’s Information
Farm Owner’s Name:
Farm Name:
Farm Address:
Description of Theft/Trespass
Approximate Date of Theft:
Approximate time:
Please provide a map and circle where the items were removed from, and where the
suspect(s) entered/exited your property, if known.
1
Describe what happened:
Description of the suspects, if any:
Description of the vehicle(s)/license plate(s), if any:
Were there any witnesses? (check one) Yes No
Name and contact information, if any:
2
Complete the following table. List the type of agricultural items taken or damaged
(produce, livestock, tools, equipment, chemicals, fertilizer, other items), estimated
weight, and value of items taken or damaged to gain entry.
Item
(Be sure to include a description of each item, such as identifiable
markings, color, serial number, etc., if known.)
Estimated weight Value
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
TOTALS: _________ _________
3
Any other information regarding agricultural items taken and/or the damage done to the
property to gain entry?
Other Information
Is there surveillance footage/trail cam? (check one) Yes No
Is there fencing? (check one) Yes No
Is there signage/No trespass? (check one) Yes No
Are there other security measures (dogs, security guards, neighborhood watch, etc.)?
Do you know your neighbors? (check one) Yes No
Name and contact information, if any:
4