Bexar County Forms

2. First Name*
4. Last Name*
6. Email:*
   Note: We will use this email address to contact you regarding your issue.
8. Date of Crash
   Date of Crash
   Note: This will help us figure out what went wrong by cross-referencing crash logs
10. Device Type*
    -- Select One --AndroidiPhone

    Note: If it’s not an Apple iPhone, then the device type is Android regardless of the brand
12. Device Brand*
    Note: e.g., Samsung, LG, Huawei
14. Device Model*
    Note: e.g., Galaxy S8, iPhone 7+, Mate 9
16. Description*
    Note: e.g., Reading about Commissioner’s Court, Viewing map of Jury Duty parking lots.
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18. 1. Receive an email copy of this form.
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