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Lumpkin County Sheriff's Office Citizen's Information Processing Form

  1. Information Source

  2. Statements and/or the investigation may conflict with the allegations, are you willing to have a polygraph or voice stress to confirm your statements and the allegations you have made?

  3. Please check one

  4. Name of:*

  5. Have you made your report verbally or written to any other officer prior to this form?

  6. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  7. Leave This Blank:

  8. This field is not part of the form submission.