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City of Auburn / Departments / Police Department / Resources / Missing children report form

Missing Children Report Form

Be very specific, the more accurate and complete the information, the better the chance of indentification. Please include a current wallet size photograph of the missing child.

IMPORTANT: Time is critical in missing children cases. It is imperative that the person completing this form make personal contact with an on-duty Auburn Police Officer. Call 260-920-3200 extension 1 to speak with an on-duty officer.

If you prefer to download and print the Missing Child Form, click here (PDF).

Child's Information
Description of child
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Last seen
:
 
 
 
 
Vehicle information
Parent or guardian information
In cases of parental abductions, a copy of the court certified order stating that the reporting parent has custody must be enclosed. (NOTE: If it is requested that the non-custodial parent's photograph be included in the bulletin, a copy of a court-certified felony warrant, which is presently in IDACS/NCIC must be made available to IMCC prior to publication of the photograph.)
Agency Information
 
Photograph of child
 
Disclosure and authorization for release of information
Disclosure of information requested is voluntary, in accordance with I.C. 10-1-7. This information will be shared with state and federal law enforcement agencies in an effort to locate missing children. Failure to provide this information may limit investigative results. All information with the exception of child's name, date of birth, and sex, will be treated as confidential and part of an official law enforcement investigation, exempt from public disclosure. *Release of Social Security Number is requested to allow its use as an investigative tool. Failure to provide this information will not result in any penalty.
I swear under penalty of perjury that I am the parent or legal guardian of the child described in this report, and that my right to the custody of said child has not been terminated or limited by the order or decree of any court of law. I hereby authorize the Indiana State Police, or any officer or employee thereof, or officer or employee of any other criminal justice agency, to disseminate the information contained in this report, including photograph, to any person or organization engaged directly or indirectly in any effort to assist in the location of missing children.
I further certify that the information in this report is true and correct to the best of my knowledge.
ELECTRONIC SIGNATURE: Your typed name represents your signature for the purpose of authenticating this record. By signing this document, you confirm that all answers provided are true and correct.
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