Derbyshire Constabulary Digital Submission

This service has been put in place to facilitate submissions of video evidence relating to driving incidents that members of the public have witnessed. Please complete the form below and upload your footage to us.

All fields marked are required

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Important Information

By making a report, you understand that you may be required to attend court in order to confirm the information given in your statement. The police will be able to support you through this process. Please note that not all cases will be heard in court. Please select an option to confirm you understand and are willing or not willing to attend court(Required)

I am willing to attend Court and give evidence in relation to this matter.

I am not willing to attend Court and give evidence in relation to this matter.

Please note, if you are unwilling to go to court it is unlikely that Derbyshire Constabulary will be able to progress this matter any further.

Click here to read FAQs

I confirm that I have read the FAQs

All statements associated with an offence or prosecution will be retained in line with the police forces retention policies. If your submission is not progressed the original copy of your statement and associated files will be deleted.

Your details

First name

Last name

Address line 1

Address line 2

Town/City

County

Post Code

Contact email address

Contact telephone number

Alternate telephone number

Preferred means of contact

Date of birth

Statement

Location, including road name and/or number

Date of incident

Time of incident

Do you know any of the parties involved?(Required)

Yes

Please provide details of the parties involved

Registration of offending vehicle

Colour of offending vehicle (if known)

Make of offending vehicle (if known)

Model of offending vehicle (if known)

You are the

Registration of your vehicle

Colour of your vehicle

Make of your vehicle

Model of your vehicle

Details of the vehicle you were in

Were you wearing reflective clothing?(Required)

Yes

Did you have your lights on?(Required)

Yes

Not required (Daytime)

Were you or the horse wearing reflective clothing?(Required)

Yes

Where was the offending vehicle in relation to you when the driving incident took place?

In your own words, describe what happened including as much detail as possible

I confirm this statement is true to the best of my knowledge and belief and I make it knowing that if it is tendered in evidence I shall be liable to prosecution if I have wilfully stated in it anything which I know to be false, or do not believe to be true.

Signed

Date

Upload your supporting files

DO NOT alter the footage before uploading, this includes adding voice overs or adding inline comments.

Footage uploaded MUST be raw original footage, with NO EDITING of any kind.

DO NOT post the footage on social media – if you have done so, please remove it.

DO NOT delete the footage from your device.

AT LEAST one minute of unedited footage, both before and after the reported incident MUST be included, so officers can assess the whole incident.

Is the date/time displayed on the footage the same as the time at which you stated the incident happened above? (Required)

Yes

Please provide a reason for the time difference - including the correct time offset in days/hours/minutes

Drop files here
or

Please be aware that your device may have recorded you and that the actions of all parties will be reviewed and action taken as appropriate.

I confirm that I understand the actions of all parties will be reviewed and action taken as appropriate.

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Important Information

Please note, if you are unwilling to go to court it is unlikely that Derbyshire Constabulary will be able to progress this matter any further.

Your details

Statement

Upload your supporting files