Reports & Forms

Below are some of the forms that the Fairfield Police Department utilizes. Choose the form that meets your needs and print a copy. Complete the form with all the required information and follow the instructions on how it needs to be submitted. Some completed forms must be brought to the Police Department while others could be mailed.

The forms are in PDF format and you will need Adobe Acrobat Reader to view and print the forms. If you do not have Adobe Acrobat reader click here.

Accident Report   Statement of Loss
Bad Check Letter   Burglar Alarm Appeal
Cell Phone Theft Report   Transient Merchant Application
Theft of Gasoline   Injury Release
Parking Tag Complaint   Pawn Sheet/Precious Metal App.
Shoplifting Report    



Parking Tag Complaint Form

If you feel that you have been incorrectly issued a parking ticket by the Fairfield Police Department you may complete this form and mail it to the Fairfield Police Department. Give us as much information as possible. The Complaint form must be received at the Fairfield Police Department by the due date on the ticket (10 days after issuance). Hold onto your ticket and you will receive a written decision on your complaint.

Parking Tag Appeal Form


Parking Tag: Petition for Violation Hearing

This form should be completed only after the Parking Tag Complaint form above has been submitted and you received a reply. You may appeal the decision made by the Fairfield Police parking tag review officer by completing the Request for Violation Hearing form. A hearing will be set up with an independent review officer who will make a decision regarding your appeal.

Petition for Violation Hearing Form




Burglar Alarm Ordinance Appeal Form

If you believe that the burglar alarm at your residence or business the Fairfield Police responded to was not a "False Alarm" you may complete this form. The appeal must be received within 30 days of the alarm. You will be notified of the hearing date and time.

Burglar Alarm Ordinance Appeal Form



Accident Reports - Late Reported

If you were involved in a motor vehicle accident in the Town of Fairfield (not including I-95 and Rte15) and failed to report the accident to the police when it occurred you can complete this form and bring it to the Fairfield Police Department to file the report. We do not investigate accidents that were not reported to us at the time they occurred but we will give you a file number for your insurance company.

Late Reported Accident Report



Cell Phone Theft Report

Complete this form if your cell phone was stolen within the Town of Fairfield. Bring the completed report to the Fairfield Police Department. You will be given a file number for your cellular provider.

Stolen / Lost Cell Phone Report



Statement of Loss

If you were the victim of a burglary or other theft and you found additional items missing that were not initially reported to the police you can complete this form and mail it or bring it to the Fairfield Police Department. Be sure your case number is on the form. The additional information will be added to your case file. Please be as specific as possible when recording stolen items.

Statement of Loss Form

Pawn Sheet / Precious Metal Dealer Application and Report Forms

This form is to be used by business who are required to complete pawn sheets and return them to the Fairfield Police Department. Follow your normal procedure for filing these forms.

Pawn Sheet

Precious Metal Application

Precious Metal Weekly Report



Shoplifting Complaint Forms

These forms are to be used by businesses in the Town of Fairfield that detain an individual for shoplifting. The person observing the violation should complete this form with all required information after calling the police. The first form is fill in the blanks (this form should only be used if the circumstances of the theft match the pre-printed form). The second form requires the complainant to write out a description of the events. Any questions should be directed to the responding police officer. The forms should be given to the police officer that responds to investigate the theft.

Shoplifting Complaint Form - Short version

Shoplifting Complaint Form - Long Version



Bad Check Letter

This form is a template letter that can be used by businesses when they receive a bad check. The letter should be mailed to the person who issued the check. For more information contact the Fairfield Police Detective Bureau at 203-254-4840. Page one contains instructions for you.

Bad Check Letter




Theft of Gasoline

This form is to be used by businesses reporting a theft of gasoline from the business. Only those businesses that want an arrest made should use this form.

Theft of Gasoline Form




Injury Release

This form is to be used by citizens participating in a Fairfield Police Department activity that would require a medical release form to be completed.

Injury Release




Transient Merchant Application

This application must be completed and submitted to the Fairfield Police Detective Bureau by anyone who wants to sell merchandise door to door or at a roadside stand within the Town of Fairfield. Refer to the Town Ordinance on Transient Merchants for information.

Transient Merchant Application