Medford Police Department
100 Main Street, Medford, Massachusetts USA 02155
Chief Leo A. Sacco, Jr.

"Quality Policing Through Community Involvement"

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Medford Police Department

100 Main Street

Medford, MA 02155

(781) 391-6404




Report Date: ______________________________   Dept Report#: ______________________________________


Victim’s name: _______________________________________________________________________________


Victim’s address:  _____________________________________________________________________________


Victim’s telephone Number: _____________________________________________________________________


Telephone numbers where victim can be reached during daytime: __________________    ___________________


Harassing Telephone Number (If known): __________________   _______________________ ________________


Type and circumstances of telephone calls:













Suspect (s) if any: ____________________________________      _______________________________________


Suspect (DOB/ADDRESS/TEL#):__________________________________________________________________


Relationship to victim if known: ___________________________________________________________________


Reporting Officer’s Signature ________________________________________      Badge# ___________________


 Reviewing Officer’s Signature___________________________________________________________________

General Information:  Making (STAR)*57 work for you – the victim’s part: It’s very easy for the person receiving the threatening/harassing call to use Call Trace. Here are the instructions:

After a threatening/harassing phone call occurs and the call has been terminated (i.e., you and the caller have hanged up) leave the phone on the hook for about 10 seconds to ensure that the call terminates

Pick up the phone and check for a dial tone. If there is no dial tone, hang up, and check again until you get a dial tone.

When a dial tone is heard, dial *57 and listen for a message regarding the trace. The telephone company automated voice will tell you whether the trace was successful or not and give you a telephone number to call.

Report all this information to law enforcement for each call you trace. 

Medford Residents/Business Owners - Please take this form to the police station to file this report