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City of Aurora

donotreply@auroragov.org

15151 E Alameda Pkwy, Aurora, CO, 80012, US

303-739-7000

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Incident Tracking Number

You will be provided with a Incident Tracking Number upon submission.

Please select all that apply

I believe the person who may be the subject of Mistreatment is:

(Optional) This person is substantially disabled due and diagnosed with:

Information regarding Mandatory Reporter

Full Name

Employment Address

Is this a financial crime?

Will this be a write off loss?

This form will be required in order for APD to pursue the investigation of a financial crime against an At-Risk Elder or At-Risk Adult with I/DD.

Form cannot be completed online.  Please print it out, complete it, and scan it, then upload it below

Financial Release Form

Upload Financial Release Authorization

Click Here to Upload

Information regarding At-Risk Elder or At-Risk Adult with I/DD

Full Name

Residential Address

Who is the primary care provider for reported victim At-Risk Elder or At-Risk Adult with I/DD?

Full Name of care provider (if not the At-Risk person)

Residential Address

Agency/Business Address

Information regarding the Accused Person (Enter the word "unknown" in any field that is not known about the suspect/offender)

Same as Primary Care Provider?

Suspect/Offender Full Name

Suspect/Offender Address