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LNEX iz. □CLEAR

SUSP. □CLOSED □

9s. APPROVAL Ss 20s. DATE18s. INVESTIGATING OFFICER I.D.17s. Distribution:Cent. Rec__Detective_Other_

2m!tin * Ir* 3D IJuv.,

.Intel.. 23s. RECt) - CENT. REC. 24s. TELETYPE NUMBER21s. REPORT REVIEW 22s. REPORTING AREA

J

•l-UHM 11 * SUPPLEMENTPOLICE DEPARTMENT(fat) 6s. DAm&Mj&sai

S SUPPLEMENT STATUS: CON’T.

s. OFF

[J FOLLOW-UP 'jg. 8$. IF MULTIPLE CLEARANCE. LIST C.C. NUMBERS

DO NOT REPEAT RESULTS OF PRELIMINARY INVESTIGATION. CLARIFY DATA, SCREENING FACTORS. PROBABLE CAUSE. ETC. ENTER ANY ADDITIONAL INFORMATION.DO NOT SUMMARIZE UNLESS NECESSARY.NARRATIVE:

10s NAME (LAST. FIRST. MIDDLE) DOB.

tIk ARRESTDATA SCI NUMBER, ARREST NUMBER. MISC. INFO.

DCK ASBL 12sNO.

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\%A I c D E F Ms CASE CONTINUANCE

?13sSCREENING

>“CTORSTSED

15s. CASESTATUS

8o z

INITIALREVISED TOTAL

FACTORS>&_

EX- (—1CLEAR 1—1SUSP. □CLOSED □

TAL 316s17s. Distribution:ent. Rec__etective_sther_

18s./INVESTIGATINGJOFFICER I.D.

K tl £Wkÿ£2&dL9SÿPPROVAL / /

23s. REC O - CENT. REC. 24S. TELETYPE NUMBER

20s. DATE I.Juv. m

.Intel. 21s. REPORT REVIEW 22s. REPORTING AREAQlrylin o p-

f is. L»IV. £S. r\s.

I 3- rv/nwi 11 * durrLCMkNI l 113 <?/.-? fg7</■POLICE DEPARTMENT4S. OFFENSE/INCIDENT

M'ÿWAq PftlSruÿ_7s SUPPLEMENT STATUS:

6s. DATEORIGINAL REPORTft 7/VrLAST, FIRST, MIDDLE5S. VICTIM/FIRM NAME_ t , MA€ M/ÿ\CONT. □ FOLLOW-UP g|ÿ

DO NOTWEPEAT RESULTS OF PRELIMINARY INVESTIGATION, CLARIFY DATA, SCREENING FACTORS, PROBABLE CAUSE, ETC. ENTER ANY ADDITIONAL INFORMATION.DO NOT SUMMARIZE UNLESS NECESSARY. -

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NARRATIVE:NAME (LAST, FIRST, MIDDLE) D.O.B.10s

MGE ARRESTDATANPA BCI NUMBER, ARREST NUMBER. MISC. INFO-

11s BLOCK 12sNO.

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A B C D E F 14s CASE CONTINUANCE13sSCREENING’ACTORS

•VISEDOTAL

15s. CASESTATUS

A:QINITIALREVISED TOTAL

FACTORS m pOPEN o>16s oEX. □ §17s. Distribution.,

Cent. Rec__Detective_Other__

CLEAR

SUSP □CLOSED O

10S. INVESTIGATING OFFICER I.D. 19s. APPROVAL

CpLt-Ut~k-r f* 270Z.20s. DATE

MUtr 19f,r CDm.Juv.. O.Intel- 21s. REPORT REVIEW 22s. REPORTING AREA 23s. REC’D - CENT. REC. 24s. TELETYPE NUMBER

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