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Part I - Describe the Alleged Offense
Alleged Offense:
Unlisted Violation
Dangerous Driving
Dangerous Cell Phone Usage
Dangerously Entering Flow of Traffic
Deliberate Blocking
Extremely Slow Driving
Ignoring Pedestrian Crossing
Lane Change - No Signal
Lane Change - Unsafe
Road Rage - Dangerous Retaliation or
Attempted Retaliation
Road Rage - Swearing/Hand Gestures/Excessive
Horn Honking
Running Red Light
Running Stop Sign
Speeding
Speeding in a School/Playground Zone
Tailgating
Unsafe Driving
Unsafe Passing
Weaving in/out of Traffic
Please
Add a Sentence/Phrase/Narrative to Describe the Offense:
(Required)
ie. Speeding in a school zone, Cut off several
people, etc
>
Part II - Describe the Offending Vehicle
Offending
Vehicle's Make:
Unknown Make
Acura
Alfa Romeo
Am General
American Motors
Aston Martin
Audi
BMW
Bentley
Buick
Cadillac
Chevrolet
Chrysler
Daewoo
Daihatsu
Dodge
Eagle
Ferrari
Fiat
Ford
GMC
General Motors
Geo
Honda
Hyundai
Infiniti
Isuzu
Jaguar
Jeep
Kia
Lamborghini
Land Rover
Lexus
Lincoln
Lotus
MG
Mazda
Mercedes-Benz
Mercury
Merkur
Mitsubishi
Nissan
Oldsmobile
Peugeot
Plymouth
Pontiac
Porsche
Renault
Rolls Royce
Saab
Saturn
Sterling
Subaru
Suzuki
Toyota
Triumph
Volkswagen
Volvo
Yugo
Offending
Vehicle's Model:
If you are unsure of the Model leave
this space blank
Offending
Vehicle's Year:
Unknown Year
2005
2004
2003
2003-2004
2000-2002
2002
2001
2000
99
98
97
96
95
94
93
92
91
90
95-99
90-95
85-89
80-84
70-79
Pre 1970
Offending
Vehicle's Color:
(Required)
ie. Red, Blue, Black, White and Red,
etc.
Offending
Vehicle's Licence Plate Number:
(Required)
Licence
Plate State or Province:
No State/Province
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
D.C.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
>
Part III - Where did
this Offense Take Place?
Street
Name:
(Required) Cross
Street:
at
(Required)
Direction
Traveling:
Unknown Direction
North
South
East
West
City
or Town:
(Required)
State
or Province:
No State/Province
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
D.C.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Country:
United States
Canada
Afghanistan
Albania
Algeria
American Samoa
Andorra
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaidjan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Bermuda
Bolivia
Bosnia and Herzegovina
Brazil
Brunei Darussalam
Bulgaria
Canada
Cayman Islands
Chile
China
Colombia
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Estonia
Finland
France
Georgia
Germany
Ghana
Greece
Grenada
Guam (USA)
Guatemala
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kuwait
Latvia
Lebanon
Lithuania
Luxembourg
Macau
Madagascar
Malaysia
Maldives
Malta
Mauritius
Mexico
Monaco
Morocco
Namibia
Nepal
Netherlands
Netherlands Antilles
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Saudi Arabia
Seychelles
Singapore
Slovak Republic
Slovenia
South Africa
South Korea
Spain
Sri Lanka
Sudan
Sweden
Switzerland
Taiwan
Tanzania
Thailand
Trinidad and Tobago
Tunisia
Turkey
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Yemen
Yugoslavia
Zimbabwe
>
Part IV - When did this Offense
Take Place?
Day,
Date,
Month,
Year
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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02
03
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Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
04
03
Hour
Minute
AM/PM?
01
02
03
04
05
06
07
08
09
10
11
12
:
00
01
02
03
04
05
06
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59
AM
PM
>
Part
V - Public Information About You
This information will be shown
alongside the citation you create for this alleged
offense. it will be public for all to see. You could
enter your first name or any descriptive handle
giving any/no indication of who you are.
Your
Public Handle:
(Required)
>
Part VI - Private Information About
You
This information is secret
and will not appear on the citation. It will only
be kept in the RoadRagers private database.
Your
Name
(Required)
ie. First and Last Name
Valid
EMail Address of Reporter:
(Valid Email Required)
Please Note
that Roadragers.com will not use this personal
information in any mailing list or email campaigns.
We will simply keep this personal info on file
for our own records. If
a valid email address is not used, and your email
bounces back to our server, your entry will not
be activated.
By
pressing the SUBMIT button below you have agreed that
all info you have submitted above is about an incident
that is alleged to have taken place and witnessed by the
submitter.You also guarantee that
the private info submitted, such as your real name and
email address are accurate.
The
private info that you have submitted will not be released
to anyone with the exception of official Law Enforcement
Agencies that may request this information in writing
using official stationary.
When you press submit - Press only
once and wait for the next screen.