Public Portal Screenshot

Public Database-public portal screenshots.docx

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 3041-0146 can be found here:

Document [docx]

Download: docx | pdf

Consumer- File A Report

Consumer- Incident Description (Tell Us What Happened)

Consumer- People & Injuries

Consumer- Product Details (Tell Us About the Product

Consumer- Contact Information

Consumer- Consent & Submit

Child Care Provider, etc (everyone but Consumer)- Contact Info

Public Safety Entity/ Government- Case Details

MECAP- People and Injuries

MECAP- Case Details

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	ssrivastava
File Modified	0000-00-00
File Created	2021-01-23