The New York Press Photographers Association

Media/Public Safety Conflict Incident Report

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Please use this form to report ANY incident that you believe to be a conflict with a Police, Fire, Emergency Medical Service or other Public Safety Agency while you are working in the capacity as a news gatherer.

Remember conflict isn't only an arrest. It is important that you record incidents where your view or line of sight is intentionally blocked or if you are removed from private property after you have permission of the owner to be there.

Please also document if you are harassed, verbally abused, if you are threatened with arrest or confiscation of your press credentials.

PLEASE NOTE: The names of anyone submitting this form will be held in confidence by the NYPPA and will not be shared without the expressed permission of the individual submitting the form. All members must understand that the NYPD is structured to rely on evidence and that without these forms we cannot PROVE there are problems. We must have the FACTS from you to take action.

Full Name
Affiliation
Telephone
E-Mail
Day of the Week
Date of Incident
Time
Check here if you were arrested
By whom?
Check here if your press card was confiscated
By whom?
Location of Incident (please be specific ex: 150 feet south of 42nd st. on 2nd Ave. Include borough and precinct, if available)

Specific Agency Involved: Include any identification possible including name, rank and shield or ID numbers if possible:

Witnesses: (Please include any contact info available)

Do you have any still photos, video or audio tapes of the incident? You may upload up to four files that you think best represents the situation.
File 1: File 2: File 3: File 4:
Do you have more materials than what we've allowed you to upload?	YES
In narrative form, including all details, please tell us what happened. Include your recollection of all conversations. Include information including important observations such as whether or not there was a supervisor present? Did you have interaction with them? Did you get any satisfaction from dealing with that superior officer? Were you treated with courtesy or were you dealt with rudely? Did you contact DCPI? Who did you speak with? Were you assisted by DCPI?

Click 'Submit' only once and wait for the next page to load. The submitting of this form may require the uploading of your file(s) and transmission to several different NYPPA liasons. Please be patient.

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