必填!
Name of Informant
(required!) |
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檢舉人身分證字號/
居留證統一證號
Informant's ID Number/ Resident Visa Number |
＊如果要領取獎勵金，此項為必填，且須檢附3張以上不同距離拍攝之照片或15秒以下影片：詳情請點閱。
＊ This information along with 3 or more photos taken from different distances or a video 15 seconds must be provided in order to receive the reward. Click here for detailed information.
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必填!
Informant's contact number (daytime) (required!)
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Informant's contact number (evening)
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Informant's fax number
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Informant's e-mail
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必填!
Informant’s address
(required!)
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(若縣市選擇新竹市或嘉義市，鄉鎮請選擇"－")
Please complete the report in Chinese to avoid errors when the system is reading the report and result in inability to further process the report. Please select "－" under township if you have selected Hsinchu City or Chiayi City under county/city
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是否需回覆
Do you require a reply notice?
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為響應環保與配合節能減碳政策，建議點選上網回覆或E-Mail回覆以減少用紙，為環保更盡一份心力！
In consideration of the environment and observing the energy-saving and carbon-reduction policy, we suggest selecting an online or email reply to minimize paper usage and help save the environment!
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本案若有處分情事，將依主管機關評定發放獎品、獎章、獎勵金等獎項，您是否希望領取
If any disciplinary action is taken against the case, a prize, medal, reward money and other awards will be granted after evaluation by the authorities. Do you wish to collect the reward?
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領取獎品或獎勵金 Collect prize or reward money
僅領取獎勵金 Collect reward money only
僅領取獎品 Collect prize only
不領取 No
感謝您參與有污染之虞車輛檢舉工作，您所留下之個人資料是主管機關寄發獎品、獎章、獎勵金時的重要依據，請確實填寫以維護您的權益。
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若您要領取獎勵金，請選擇領取方式
Please select a collection method if you wish to collect the reward money.
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