Race and Officer Interaction Data Collection Tool

Date: Officer Name: Interaction Background Stop Type: Motor Vehicle Bicycle Pedestrian Interaction Reason: Hazardous Moving Violation Non-Hazardous Moving Violation CFS Related Investigatory Stop Civilian Assistance General Broadcast DUI Interaction Outcome: Verbal Warning Hazardous Traffic Citation Non-Hazardous Traffic Citation Warrant Arrest Made New Charge Arrest Made Civilian Characteristics Gender: Male Female Race/Ethnicity: White Black Asian Incident Number: Officer Personnel Number:

Pacific Islander Native American Middle Eastern/East Indian Hispanic Eastern European How Race Identified: Visually Civilians Speech Civilians Name Civilians Self Report Search Conducted? No Yes Vehicle Searched Person Searched Authority For Search: Incident To Arrest Search Warrant Officer Safety Frisk Consent Search Inventory Search Contraband Found? Yes No Property Seized? Yes No Reportable Force Used? Yes No

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