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Police Statement Form

Police Statement Form Template for Malaysia

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Police Statement Form

"I need a Police Statement Form to report a cybersecurity breach at our corporate office that occurred on March 15, 2025, involving unauthorized access to our company's financial data servers and potential theft of sensitive information."

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Document background
The Police Statement Form is a fundamental document in Malaysia's legal and law enforcement system, used to record official statements from individuals regarding various incidents, crimes, or matters requiring police intervention. This document is essential when reporting crimes, accidents, loss of property, or any incident requiring official police documentation. The form must comply with Malaysian legislation, including the Criminal Procedure Code (Act 593), Police Act 1967, and Evidence Act 1950. It captures crucial information such as personal details of the declarant, comprehensive incident descriptions, witness information, and any relevant supporting evidence. The statement can be used in court proceedings and serves as an official record of events, making accuracy and completeness crucial.
Suggested Sections

1. Statement Header: Official police department letterhead, reference number, and date of statement

2. Personal Information: Details of the person making the statement including full name, IC/passport number, age, occupation, address, and contact information

3. Declaration of Truth: Standard declaration that the statement is true and made voluntarily

4. Incident Details: Date, time, location, and comprehensive description of the incident

5. Chronological Narrative: Detailed account of events in chronological order

6. Witness Information: Details of any witnesses to the incident

7. Statement Closure: Time statement completed, signature of declarant and recording officer

Optional Sections

1. Vehicle Information: Used in cases involving vehicles - includes registration numbers, make, model, and damage details

2. Property Details: For cases involving property loss or damage - includes description, value, and ownership details

3. Injury Description: For cases involving personal injury - includes nature and extent of injuries

4. Suspect Description: Used when there are unknown perpetrators - includes physical description and distinguishing features

5. Digital Evidence Reference: Used when there is CCTV, photos, or other digital evidence related to the case

6. Translator Details: Required when statement is given in a language other than Bahasa Malaysia or English

Suggested Schedules

1. Photograph Annexure: Attached photographs of injuries, damage, or crime scene

2. Sketch/Map Appendix: Drawings or maps showing location of incident or relevant details

3. List of Lost/Stolen Items: Detailed inventory of items involved in theft or loss cases

4. Medical Report Reference: For cases involving injuries - attached medical reports or references

5. Evidence Receipt: List of physical evidence handed over to police during statement recording

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈË°æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
Relevant legal definitions


























Clauses




















Relevant Industries

Law Enforcement

Legal Services

Insurance

Banking and Finance

Retail

Manufacturing

Transportation

Healthcare

Education

Hospitality

Security Services

Construction

Real Estate

Relevant Teams

Legal

Compliance

Risk Management

Security

Human Resources

Operations

Facilities Management

Health & Safety

Internal Audit

Corporate Affairs

Loss Prevention

Relevant Roles

Legal Counsel

Compliance Officer

Risk Manager

Security Manager

Human Resources Director

Facility Manager

Operations Manager

Insurance Claims Manager

Safety Officer

Corporate Secretary

Loss Prevention Manager

Internal Auditor

General Manager

Chief Security Officer

Industries







Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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