Gloucestershire Constabulary

This service has been put in place to facilitate submissions of video evidence relating to driving incidents that members of the public have witnessed. If the footage you wish to send us involves a vehicle collision, please do not continue further and please use the below link to complete the correct form.

A matter involving driving, vehicles or a road traffic incident | Gloucestershire Constabulary

To continue submit evidence of a road traffic offence, please complete the form below and upload your footage to us.

Failed to send your application. Please check your application and try again.

Important Information

Completing this online form will produce a statement that could form part of a prosecution case. By making this report, you understand that you may be required to attend court to confirm the information you give. The police will be able to support you through this process. Please note that not all cases will be heard in court and most cases are resolved before this is necessary. *(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.

Disclaimer

Click here to read FAQs

I confirm that I have read the FAQs. This answer will not be included as part of your statement. *

I confirm that I am aged 18 or older *

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. This answer will not be included as part of your statement. *

Your details

Your address and contact details are recorded separately and this personal information is protected and will not be disclosed to the other person or their solicitor. Also, witnesses are not usually asked to give their address out loud in court. The defendant or his or her solicitor is normally told the name of any witnesses.

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 of incident

Please be as accurate as possible to help identify the exact location e.g. East Street near to the junction with Abbey Road, Newtown. If the location is in the countryside, please identify the road number or name and a nearby landmark e.g. “B8899 approximately ½ mile from Newtown Cross.

Date of incident

Time of incident

Registration of offending vehicle

Make of offending vehicle (if known)

Model of offending vehicle (if known)

Do you know the driver or rider of the other vehicle?(Required)

Yes

How do you know the offender

At the time of this incident I was

Registration of your vehicle

Make of your vehicle

Model of your vehicle

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

In your own words, describe what happened including as much detail as possible. Your description of this incident must be recorded. Do not write ‘see footage’ as we will be unable to proceed with your submission.

What device was used to record this incident?

How was the device fitted/secured?

How does your device record and or store footage?

When viewed, does the footage you have recorded display the time? Choose ‘Yes’ if the recorded footage shows either the date, the time or both the date and time.(Required)

Yes

Some devices automatically record the date and time with your footage. If the device wasn’t set up before use then the time shown on the recorded footage will not be accurate. Please choose one of the following statements:

The time displayed on the recorded footage is not correct because the device was not set up with the date and time prior to use. The date and time of the incident recorded in my statement is correct.

The date and time of the incident recorded in my statement is correct. The time displayed on the footage reflects this.

I confirm I leave the question of prosecution or other disposal in the hands of the police. This answer will not be included as part of your statement. *

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 two minutes of unedited footage, both before and after the reported incident MUST be included, so Police Prosecutor can assess the whole incident.

Please do not upload files names with insulting words, we will not be able to process them.

If you have any issues with completing this form, support can be contacted to assist. Please click here to contact support.

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.

The release of my Contact Details For Civil Litigation Purposes(Required)

I give consent

I do not give consent

Permission for the CCTV/Dash Cam video footage to be disclosed for civil litigation purposes.(Required)

I give consent

I do not give consent

The release of my Witness Statement and/or exhibits In their entirety.(Required)

I give consent

I do not give consent

Attachment Security Check Failed

500 - Internal Server Error

Important Information

Disclaimer

Your details

Statement

Upload your supporting files