Statement Form

If you were requested by a member of the Chesterfield Police Department to complete a written statement, please access the form by selecting the link below. In most cases, it is recommended that the written statement be dropped off at the Chesterfield Police Department. There are times in which it would be appropriate to email, mail or fax the statement. Please contact the investigating officer to see how he/she would like to receive the statement from you. Our mailing address is P.O. Box 231 Chesterfield NH 03443, fax line (603) 363-4152. Please contact us if you have any questions about completing this form.

Statement Form (fill out on computer)

Statement Form (fill out by hand)

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