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The following items are needed in order to proceed with Credit/Debit Card Abuse case(s). After it is confirmed that the offense occurred in the City Limits of Tomball, please check each item that you have possession of. Packets received without one or more of the following items may be returned or suspended with no investigative follow up completed. A case number will NOT be assigned until all submitted information has been reviewed. Incomplete packets may be returned or suspended and not investigated.
REQUIRED ITEMS
Completed Credit/Debit Card Abuse Report for each unauthorized transaction
1. Victim Completed
1. TPD USE
Copy of credit card or bank statement bearing victim’s name and full credit/debit card number.
1. Victim Completed
1. TPD USE
From the bank or credit card company: a copy of a signed affidavit or charge dispute form or fraud form.
1. Victim Completed
1. TPD USE
Completed victim/witness statement describing in detail what occurred.
1. Victim Completed
1. TPD USE
Victim signature, date and time turned in.
1. Victim Completed
1. TPD USE
Victim Type
Date Reported
Date Reported
Date Reported
TPD Case Number
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First Name
Victim Information
Last Name
Date of Birth
Race/Sex
Hair/Eyes
Height/Weight
Drivers License Number
State
Cell Phone Number
Home Phone Number
Address1
Business Address
City
State
Zip
Location where Crime Occurred
City
State
Zip
Date and time transaction occurred
Date and time transaction occurred
Date and time transaction occurred
Card Type
Account Type
Credit Card Number
Amount Charged
Bank Name
Bank Account #
Bank Contact Person
Additional Name(s) on Bank Account
Phone Number
Address
If debit transaction, provide information on how PIN # may have been obtained
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If the following information is available at the time of reporting, provide the information on the person who accepted the CREDIT/DEBIT Card transaction.
First Name
Last Name
Drivers License
State
Address1
City
State
Zip
Work Schedule Days/Hours
Phone Number
Please provide any additional witness information if available
Please provide any information known on a suspct(s) and or suspect vehicle
Description of suspect (race, sex, age, hgt, wgt, eye color, hair color/length, clothing)
Description of suspect vehicle (make, model, year, doors, color, etc)
Type of identification used
Was the person who passed the card the same person who was pictured on the ID?
Has the suspect been in your business prior to today?
Do you believe you could recognize the suspect if you saw him/her again?
Did you see the suspect use the card?
Was the transaction videotaped?
Is the videotape available to provide to law enforcement?
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Who is currently suffering the financial loss associated with this charge?
Has the account holder been contacted?
Were other charges made, at other locations, according to the victim?
Is there any known relationship between the account holder and the suspect?
If YES, pleas specify known relationship
What was the explanation given by victim on how suspect obtained the card?
What were the suspects statements, if any, before, during and after the transaction?
An officer does not need to respond unless the credit card abuse is in progress. Please contact (281) 351-5451 (Tomball PD Dispatch) if you have any questions. Only one case number is needed. After completing report packet, please deliver in person of by certified mail the following: • Credit / Debit Abuse Report • Completed Victim Statement • Signed Affadavid of Credit / Debit Card Abuse, and the • Bank or credit card statement to: Tomball Police Department 400 Fannin Street Tomball, Texas 77375

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