ACT Policing Online Services

Petrol drive off

Form steps

  • Step 1 Contact details
  • Step 2 Details of offence
  • Step 3 Offender details
  • Step 4 Acknowledgement
Step 1
Step 2
Step 3
Step 4
What Police action are you requesting?
Service station details

    Is the company address the same as the site address? *

    Console operator details

    Were you the console operator at the time of the incident? *

    Name of person completing the form
      Details of offence
      Dollars and cents. e.g. $90.50
      Litres and millilitres. e.g. 40.55 L
      Include a description of what occurred including if the offender entered the store, if the offender spoke to the operator and whether or not the offender made arrangements to pay.
      Vehicle details
      Including details of bull bars, body kits, spot lights, mag wheels, roof racks, stickers/pinstripes etc.

      Do you recognise the vehicle or offender from previous Drive Off incidents? *

      Supporting evidence

      Was the incident captured by CCTV? *

      Offender details
      Including details of any glasses, tattoos, beard, scars or physical deformities.
      Acknowledgement

      I acknowledge that any statements made by me in this report accurately set out the evidence which I would be prepared, if necessary, to give in court as a witness. Any such statement is true to the best of my knowledge and belief, and I make it knowing that, if it is tended in evidence, I shall be liable to prosecution if I have wilfully stated anything which I know to be false, or do not believe to be true. *