38
509 M W 54 04/08/1963 160 FL0410400 26 00 1145 01 01 01 00 00 PORTALATIN 5218 6TH AVE DR W 34209 BRADENTON P-634-160-63-128-0 Holmes Beach Police Department 1145 1145 1206 20170294 DAVID DRIVERS LICENSE 01 Thu 01 STATE OF FLORIDA 2 N N V 0 2 A 0 0 0 00 00 00 FL MED THN FL 01 PATROL 1 A CA J. PIERCE SGT. V. MCGOWIN 304 201 2 9000 324 C DRIVERS LIC ___-____ ___ ___-__-____ ___ ___-____ ___-____ ___ ___ ___-____ ___-____ ___ ___ ___-____ 34217 50TH ST HOLMES BEACH 100 0 4 1 309 1 N 2 1 00. N/A 01. Gunshot 02. Stabbed O F F / I N C I n d i c a t o r EVENT DATA NARRATIVE SUSPECT CODES ADM A-Attempted C-Committed A-Attempted C-Committed Area T y p e o f W e a p o n 01. Residence Single 02. Apartment/Condo 03. Residence-Other 04. Hotel/Motel Time (mil) Gang Related Time Dispatched (mil) Primary Offense Description 21. Employer 22. Landlord/Tenant 23. Acquaintance 99. Other Known 5. Ordinance 9. Other Zone ) Agency Report Number 3. Misdemeanor 4. Traffic Misdemeanor OFF/INC # 1 Business Name/Area Identifier District NCIC/UCR Code 2. No L o c a t i o n T y p e V / W C o d e # Victims 00. N/A 01. Handgun 05. Knife/Cutting Instrument 06. Blunt Object 07. Hands/Fist/Feet 08. Poison 09. Explosives 10. Fire/Incendiary 11. Threat/Intimidation 12. Simulated Weapon V - Victim W - Witness C - Reporting Person O - Other R a c e N - N/A M - Male F - Female U - Unknown R e s i d e n c e T y p e 0. N/A 1. City 2. County E x t e n t o f I n j u r y R e s i d e n c e S t a t u s 03. Laceration 04. Unconscious 05. Poss. Broken Bones 06. Poss. Internal Injury V i c t i m R e l a t i o n s h i p T o O f f e n d e r 07. Loss of Teeth 08. Burns 09. Abrasions/Bruises 99. Other 06. Parent 07. Brother/Sister 08. Child 09. Step-Parent 10. Step-Child 11. In-Law 12. Other Family 13. Student Residence Phone Business Phone Juvenille Occupation Height Weight Eye Color Hair Length Hair Style Nickname/Street Name Place of Birth Social Security Number SCIC/NCIC Employer/School Teeth Speech/Voice Special Identifiers Original Day Reported Date Time (mil) Time Arrived (mil) Time Completed (mil) 1. Felony 2. Traffic Felony To Time (mil) ( - Type 15. Industrial/Mfg. 16. Storage 17. Gov't/Public Bldg. 18. School/University 19. Jail/Prison 20. Religious Bldg. 21. Airport 22. Bus/Rail Terminal 23. Construction Site 24. Other Structure 25. Parking Lot/Garage 26. Highway/Roadway 27. Park/Woodlands/Field 28. Lake/Waterway 29. Motor Vehicle 10. Dept/Discount Store 11. Specialty Store 12. Drug Store/Hospital 13. Bank/Financial Inst. 14. Commercial/Office Bldg. S u s p e c t C o d e Incident Location (Street Number, Street, Apt,) Scars/Marks/Tatoos (Location/Describe) OFFENSE-INCIDENT REPORT 0. N/A 1. Occupied E-Escapee M-Missing From Date of Supplement - ( 17. Friend 18. Neighbor 19. Sitter/Day Care 20. Employee O F F / I N C I n d i c a t o r OBTS Number (Arrested) Other I.D. Number Immigration and Naturalization Number I n c i d e n t T y p e Incident: Day Date 2. Unoccupied 3. Abandoned 05. Convenience Store 06. Gas Station 07. Liquor Sales 08. Bar/Nightclub 09. Supermarket Date Day 0. N/A 1. Yes F o r c e d E n t r y O c c u p a n c y Statute Violation Number - Chapter, Section, Sub Description Type Hair Color Facial Hair Build Complexion Driver's License Number/State Address Code Maiden Name Name (Last, First, Middle) 13. Drugs 88. Unknown 99. Other Grid V i c t i m T y p e 0. N/A 1. Juvenile 2. L.E. Officer 3. Adult 4. Business 5. Government 6. Church 9. Other S e x I - American Indian O - Oriental/Asian U - Unknown N - N/A W - White B - Black 3. Florida 4. Out-of-State 0. N/A 1. Full Year 2. Part Year 3. Non-Resident 0. None 1. Minor 2. Serious 3. Fatal 14. Teacher 15. Child of Boy/Girl Friend 16. Boy/Girl Friend 03. Spouse 04. Ex-Spouse 05. Co-Habitant 00. N/A 01. Undetermined 02. Stranger I n j u r y T y p e Clothing (Describe) Zip State City 02. Rifle 03. Shotgun 04. Firearm # Prem. Ent. S-Suspect A-Arrestee Zip City # OFF/INC. # Offenders # Veh. Stolen 1.#1 2.#2 3.Both ) If V/W Code is V, W or C Fill in this Line O F F / I N C I n d i c a t o r V/W Code # Name (Last, First, Middle or Business) Residence Phone Business Phone Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge? Synopsis of Involvement V. Type V/W Code # Name (Last, First, Middle or Business) Residence Phone Business Phone Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge? Synopsis of Involvement V. Type Extent of Injury Res. Status Res. Type Zip State City Extent of Injury Res. Status Res. Type Zip State City VICTIM / WITNESS VICTIM / WITNESS Dom. Violence Dom. Violence 1.#1 2.#2 3.Both 1.#1 2.#2 3.Both Date of Birth Age Date of Birth Age If V/W Code is V, W or C Fill in this Line Address (Street, Apt. Number) Other Contact Info. (Time Available, Interpreter, etc.) Address (Street, Apt. Number) Other Contact Info. (Time Available, Interpreter, etc.) Last Known Address (Street, Apt. Number) OFF/INC # 2 R-Rec. Missing Z-other Person/Unit Notified Case Status Time Routed To Referred To Related Report Number(s) Unit of Page Number Arrested C l e a r a n c e T y p e E x c e p t i o n T y p e 2. Arrest on Primary Offense Secondary Offense Without Prosecution 3. Death of Offender 4. V / W Refused to Cooperate 3.Unfounded Page 5. Prosecution Declined 6. Juvenile/No Custody 1.Extradition Declined 1.Arrest 2.Exceptional Jail Number OBTS Number Date Cleared ADMINISTRATIVE A-Adult J-Juvenile Date Name of Officer Reporting Officer Reviewing (If Applicable) I.D. Number I.D. Number/Locator Code By Date Assigned To 30. Other Mobile 99. Other Susp.# Juvenile Warn/Dismiss: 1. Original 2. Supplement: Juvenile in Report: __/__/____ 04/13/2017 04/13/2017 __/__/____ USA Rev. 01/23/2003 Thu Thu 04/13/2017 04/13/2017 Sex Date of Birth Race Age 04/13/2017 Yes No Yes No 0 Signature of Officer Reporting Signature of Officer Reviewing C O P Y

FL0410400 OFFENSE-INCIDENT REPORT M D Holmes …holmesbeachfl.org/Cities/COHB/documents/20170420.pdf · Holmes Beach Police Department 1145 1145 1206 ... 100 50TH ST HOLMES BEACH

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509MW 5404/08/1963 160

FL0410400

2600

1145

01 01 01 00 00

PORTALATIN

5218 6TH AVE DR W 34209BRADENTON

P-634-160-63-128-0

Holmes Beach Police Department1145 1145 1206

20170294

DAVID

DRIVERS LICENSE

01

Thu

01 STATE OF FLORIDA

2 NN

V 0

2A

0 0 0 00 0000

FL

MED THN

FL

01

PATROL

1 ACA

J. PIERCESGT. V. MCGOWIN 304

201 2 9000324CDRIVERS LIC

___-_______

___-__-____

___ ___-____

___-__________ ___-____

___-__________ ___-____

3421750TH ST HOLMES BEACH1000

4

1

309

1

N2 1

00. N/A01. Gunshot02. Stabbed

OFF/INC Indicator

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

TC

OD

ESA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair Color

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2 3.Both

)

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____04/13/2017

04/13/2017__/__/____

USA Rev. 01/23/2003

Thu Thu04/13/2017 04/13/2017

Sex Date of BirthRace Age

04/13/2017

Yes No

YYeess NNoo

0

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Holmes Beach Police Department

DRIVERS LICENSE

2 1

01

PATROL

1 ACA

J. PIERCESGT. V. MCGOWIN 304

309

ON 04-13-17 WHILE ON PATROL I OBSERVED A BLUE DODGE SUV BEARING FL TAG #CBKI48 TRAVELING SOUTH ON GULFDR. UPON RUNNING THE TAG AND REGISTERED OWNER/DRIVER THROUGH FCIC/NCIC THE DRIVER'S LICENSE WASSUSPENDED AS OF 04/11/2017 FR-SUSP NON-JUDGEMENT SUSPENSION. I CONDUCTED A TRAFFIC STOP ON THE VEHICLEAT THE 100 BLK OF 50TH ST FOR THE DRIVER BEING SUSPENDED. UPON SPEAKING WITH THE DRIVER (DAVID,PORTALATIN) HE PROVIDED A PAPER FROM HIS INSURANCE THAT ADVISED HIS INSURANCE HAD LAPSED AND WASTEMPORARILY REINSTATED AS OF 03-16-17. IT INSTRUCTED HIM TO PROVIDE PROOF OF INSURANCE TO THE DHSMV.HE WAS UNABLE TO PROVIDE ME WITH PROOF OF INSURANCE ON THE VEHICLE. I ISSUED HIM A SUMMONS FOR DRIVINGON A SUSPENDED LICENSE UNDER THE FR SUSPENSION AS HIS INSURANCE HAD LAPSED.CITATION: A2H5L3E

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

04/13/2017

04/13/2017__/__/____

04/13/2017

USA Rev. 01/23/2003

20170294FL0410400

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

Holmes Beach Police Department FL0410400

26

00

1431

01 01 01 00 00

STATE OF FLORIDA

520 13TH ST W APT 24A 34221PALMETTO

HOUSE CLEANER

V622544817960

500

1431 1431 1530

35

20170295

MEXICO

520 13TH ST WEST APT A24 PALMETTO 34221

OWNER

RAMIREZERRAS LUIS DANIEL

DRIVER LICENSE

Thu Thu

Thu

2 NN 0 0 0 00 0000

1

1

V 5

O 3

FL

VARGAS MARIA DELCARMEN1 2A

FW BRO BRO

FL

M W

MED THN

FL

03 1 90004 322CDRIVERS LIC

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

34217SR 64 HOLMES BEACH700

0 1

THE DEFENDANT WAS STOPPED FOR DRIVING IN A BIKE LANE TWICE AND WHEN STOPPED STATED THAT SHE DID NOTHAVE A DRIVERS LICENSE. DEFENDANT WAS ISSUED A NOTICE TO APPEAR ON NO DRIVERS LICENSE AND CITATIONSFOR DRIVING IN A BIKE LANE AND NO PROOF OF INSURANCE. VEHICLE WAS IMPOUNDED BY TOW COMPANY.

01

PATROL

1 ACA

SGT. M. PILATO

SGT. M. PILATO 306

306

1

1

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

T

00. N/A01. Gunshot02. Stabbed

CO

DES

AD

M

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 2

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

Residence Phone

Business Phone

Juvenile

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

30. Other Mobile99. Other

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

0. N/A1. Occupied

E-EscapeeZ-Other

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

Susp. #

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

# Prem. Ent.

S-SuspectA-Arrestee

Dom. Violence

Dom. Violence

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

Age

Date of Birth Age

Date of Birth Age

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

V. TypeOFF/INC Indicator

If V/W Code is V, W or CFill in this Line

1.#12.#2

3.Both

OFF/INC Indicator

If V/W Code is V, W or CFill in this Line

1.#12.#2

3.Both

Person/Unit Notified

Case Status

Time

Routed To Referred

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

1. Original2. Supplement

Juvenilein Report

JuvenileWarn/Dismiss

1

__/__/____

04/13/2017

04/13/2017 04/13/2017

04/13/2017

04/13/2017

__/__/____

08/16/1981

Signature of Officer Reporting

Signature of Officer Reviewing

Yes No

YYeess NNoo

12 NOFFENSE-INCIDENT REPORTGangRelated

C O P

Y

AD

M

1100.. OOtthheerr -- SSppeecc..66.. TTrraannss..

77.. EEnnggiinnee PPaarrttss

1. Key

11.. KKeeyy

3. Hot Wire

6. Trans.

7. Engine Parts

8. Major Body Parts

VEH

ICLE

/VES

SEL

1. Original2. Supplement

Date of Supplement

Reg. State

Date Recovered

LengthVessel Name

StyleModelStatusPerson #

1. Local / Local2. Local / Other3. Other / Local

Tag Type

Primary Offense Description Victim #1 Name (Last, First, Middle)

Person Code Status Code Damage Code Type Recovery Location Recovery Code Stolen / Recovered

Holmes Beach Police Department

1. Stolen2. Recovered3. Stolen and Recovered4. Suspicious

5. Impounded6. Abandoned7. Fail Return8. Seized9. Other

0. N / A1. Arson2. Criminal Mischief3. During Other Offense

1. Auto2. Truck / Van3. Motorcycle4. Camper / RV5. Bus

6. Trailer7. Boat8. Aircraft9. Other

VEHICLE REPORT

Original Date Reported

Agency Report Number

Description (Identifying Characteristics, Noticeable Damage, Interior Color, etc)

Tag Reg./Doc. # Reg. Year Decal Number

VIN/Hull/FAA Estimated Value

Propulsion

Insurance Company Lien HolderCondition

Hull Material Boat Type

Recovery Address/Geographic Indicator

Recovery Loc. Recovery Code Original Reporting Agency Report Number Reason/Authority

SCIC/NCIC Location of Original Theft

Value Recovered

1. Window Closed

HGSQ831G2HZ5417Y4256329

2. Locked 3. Keys in Ignition

SILVER Color (Top/Bottom)

Towed By

Components Stripped

0. N/A 5. Interior 9. Tag/Decal Stolen

10. Other - Spec.0. N/A 8. Unk.2. Tow Truck 4. Steering

5. Ignition 1. VIN Plt.

4. Battery

Person Code Damage Type Year Make

2000 PONTAC GRAN P 4DSD

Storage Location

V- VictimS- SuspectA- ArresteeO- Other

5. Park / Playground6. Shopping Mall7. Woods8. Water9. Other

1. Family Residence2. Apt. Complex3. Housing Project4. Commercial / Industrial

4. Stripped / Theft From9. Other

CO

DES

VEH

ICLE

/VES

SEL

VEH

ICLE

INV.

/NA

RR

ATI

VE

Person Code Person # Status Damage StyleModelType Year Make

Reg. State Tag TypeTag Reg./Doc. # Reg. Year Decal Number

VIN/Hull/FAA Estimated Value

Insurance Company Lien HolderCondition 1. Window Closed 1. Window Closed 2. Locked 2. Locked 3. Keys in Ignition 3. Keys in Ignition

Description (Identifying Characteristics, Noticeable Damage, Interior Color, etc) Color (Top/Bottom)

LengthVessel Name PropulsionHull Material Boat Type

Date RecoveredRecovery Address/Geographic Indicator Value Recovered

Recovery Loc. Recovery Code Original Reporting Agency Report Number Reason/Authority

Methodof Theft

00.. NN//AA 88.. UUnnkk..22.. TTooww TTrruucckk

33.. HHoott WWiirree

44.. SStteeeerriinngg

55.. IIggnniittiioonn

Components Stripped

00.. NN//AA 55.. IInntteerriioorr

88.. MMaajjoorr BBooddyy PPaarrttss

99.. TTaagg//DDeeccaall SSttoolleenn11.. VVIINN PPlltt..

44.. BBaatttteerryy

Location of Original TheftTowed By Storage Location SCIC/NCIC

Vehicle #

HoldY - YesN - No

HoldY - YesN - No

Vehicle #

Methodof Theft

2. Tires/Wheels

3. Radio/CB

22.. TTiirreess//WWhheeeellss

33.. RRaaddiioo//CCBB

FL

Case Status

Routed To Referred To

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

01

PATROL

ACA

SGT. M. PILATOSGT. M. PILATO 306

306

Arrest Number

20170295DRIVERS LICENSE STATE OF FLORIDA

11 05O 1

1

2017

1

__/__/____

__/__/____

04/13/2017__/__/____

04/13/2017

USA Rev. 01/21/2003

__/__/____

04/13/2017

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

600MW 5507/07/1961 200 BLU BRO M

FL0410400

12

00

0207

01 01 01 00 00

GEE

1911 70TH ST CT E 34208BRADENTON

NA NA

G000799612470

Holmes Beach Police Department

0207 0207 0240

20170297

UNKNOWN

NA

SHERMAN W

COV/OTHER

01

Fri

01 CITY OF HOLMES BEACH

5801 MARINA DR HOLMES BEACH 34217

2 NN

V 5

A

0 0 0 00 0000

FL

FL

LT THN C

FL

PATROL

C.LABRANCHE

SGT. V. MCGOWIN 304

0 0 00000CCOV/OTHER

708-5804941

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

34217

WALGREENS

E BAY DR HOLMES BEACH3200

0

5

1

318

1

N2 1

00. N/A01. Gunshot02. Stabbed

OFF/INC Indicator

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

TC

OD

ESA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair Color

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2 3.Both

)

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____

04/14/2017

04/14/2017

__/__/____

USA Rev. 01/23/2003

Fri Fri04/14/2017 04/14/2017

Sex Date of BirthRace Age

__/__/____

Yes No

YYeess NNoo

0

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Holmes Beach Police Department

COV/OTHER

1 1

PATROL

C.LABRANCHE

SGT. V. MCGOWIN 304

318

ON 4/14/17 AT 0207 HRS I OBSERVED SHERMAN GEE SLEEPING ON A BENCH AT WALGREENS, 3200 E BAY DR. INHOLMES BEACH. GEE HAD HIS HEAD PROPPED UP ON A TRASH BAG, WAS COVERED IN A BLANKET, AND DID NOT AWAKEFOR APPROXIMATELY 10 MIN WHILE I HAD MY VEHICLE RUNNING NEARBY. HE WAS ISSUED A NOTICE TO APPEAR FORCOV CAMPING AND WAS GIVEN A COURT DATE OF 5/16/17 AT 8:30HOURS IN COURTROOM 6-C. I EXPLAINED THETICKET TO GEE AND HE REFUSED TO SIGN. HE WAS ISSUED THE NOTICE TO APPEAR AND LEFT THE AREA. ICLEARED WITH NO FURTHER ACTION.

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

04/14/2017

04/14/2017

__/__/____

__/__/____

USA Rev. 01/23/2003

20170297FL0410400

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

6-00MW 6907/20/1948 180 BRO GRY S

FL0410400

26

00

0937

1 1 1 00 00

LINDSEY

2010 MANATEE AVE. E. 34208BRADENTON

UKNOWN UNKNOWN

L-532-724-48-260-0

Holmes Beach Police Department

0937 0937 0947

0937 0937

20170299

RONNIE DAWSON

COV/ALCOHOL

1

Fri

1 CITY OF HOLMES BEACHV 9

2Z

FL

LT THN B

FL

PATROL

1

JASON HIGGISN

SGT. V. MCGOWIN 304

6 6-3A 00000ACOV/ALCOHOL

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

3417 W80MANATEE AVE. W. HOLMES BEACH600

0

5

1

2

331

1

SHORT/SHIRT

N2 1

00. N/A01. Gunshot02. Stabbed

OFF/INC Indicator

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

TC

OD

ESA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair Color

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2 3.Both

)

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____

04/14/2017

04/14/2017

__/__/____

USA Rev. 01/23/2003

Fri Fri04/14/2017 04/14/2017

Sex Date of BirthRace Age

__/__/____

Yes No

YYeess NNoo

0

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Holmes Beach Police Department1 1

PATROL

22

JASON HIGGISN

SGT. V. MCGOWIN 304

331

I MADE A RIGHT TURN ONTO 6TH AVE. FROM MANATEE AVE. AT THE BUS STOP, I OBSERVED A WHITE MALE INMID SWIG OF A GLASS BOTTLE OF LANDSHARK BEER. AS SOON AS SUBJECT SAW THAT THE VEHICLE THAT WAS SLOWINGDOWN TO LOOK AT HIM WAS A MARKED PATROL TRUCK, HE TRIED TO CONCEAL THE BOTTLE BACK INTO ONE OF THE TWOSIX PACKS THAT WERE SITTING NEXT TO HIM. I APPROACHED SUBJECT AND OBSERVED 3 OTHER EMPTY BEER BOTTLESNICELY PLACED BACK INTO ONE OF THE SIX PACKS.

SUBJECT WAS GIVEN A CITY ORDINANCE TICKET AND SIGNED UPON RECEIPT OF IT. NO FURTHER ACTION TAKEN.

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

04/14/2017

04/14/2017

__/__/____

__/__/____

USA Rev. 01/23/2003

20170299FL0410400

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

Holmes Beach Police Department FL0410400

29

00

0020

01 01 01 00 00

STATE OF FLORIDA

2209 9TH AVE E 34208BRADENTON

M650-280-80-207-0

WHITE TSHIRT BLUE JEANS

55 160

0020 0020 0100

0020 0100

36

20170301 LICENSE

Sat Sat

Sat

2 NN 3 0 0 00 0000

1V 5

FL

MORENO GABRIEL1 2A

MW BLK BLK

FL

S S

MED MED

FL

34 10b1 90004 322CDRIVERS LIC

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

0034217 00 00 00

ROADWAY

MANATEE AVE HOLMES BEACH800

0 0

VEHICLE STOPPED AT THE ABOVE LOCATION FOR SPEEDING, 51 MPH ON A 35 MPH ROADWAY. FCIC SHOWED ABOVEDRIVERS LICENSE WAS SUSPENDED ON 01-29-2007. THE TAG ON THE VEHICLE, TX #DBF9159 IS REGISTERED TOABOVE, DOES NOT BELONG ON VEHICLE. 1997 FORD EXPLORER, VIN #1FMCU22X6VUA28582 OWNED BY CRUZ TOWING,4900 15TH ST E , BRADENTON, BUT NOT REGISTERED. MALE ISSUED 3 VIOLATIONS.

11

FRASER

SGT.COPEMAN 307

323

1

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

T

00. N/A01. Gunshot02. Stabbed

CO

DES

AD

M

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 2

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

Residence Phone

Business Phone

Juvenile

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

30. Other Mobile99. Other

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

0. N/A1. Occupied

E-EscapeeZ-Other

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

Susp. #

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

# Prem. Ent.

S-SuspectA-Arrestee

Dom. Violence

Dom. Violence

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

Age

Date of Birth Age

Date of Birth Age

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

V. TypeOFF/INC Indicator

If V/W Code is V, W or CFill in this Line

1.#12.#2

3.Both

OFF/INC Indicator

If V/W Code is V, W or CFill in this Line

1.#12.#2

3.Both

Person/Unit Notified

Case Status

Time

Routed To Referred

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

1. Original2. Supplement

Juvenilein Report

JuvenileWarn/Dismiss

1

__/__/____

04/15/2017

04/15/2017 04/15/2017

__/__/____

04/16/2017

__/__/____

06/07/1980

Signature of Officer Reporting

Signature of Officer Reviewing

Yes No

YYeess NNoo

12 NOFFENSE-INCIDENT REPORTGangRelated

C O P

Y

2501/18/1993

FL0410400

26

05

1338

1 1 1 1 0

HERNANDEZ

104 59TH ST. E. APT B 34203BRADENTON

Holmes Beach Police Department

1338 1338 1440

1338 1338

20170302

LEONARDO GARCIA

CRIMINAL TRAFFIC

1

Sun

Sun Sun

1 STATE OF FLORIDA

2 NN

MW

V 5

2A

0 0 0 00 0000

FL

01

PATROL

1

1 ACA

JASON HIGGINS

SGT. M. PILATO 306

03 1 9000322CDRIVERS LIC

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

34217 W8036TH ST. HOLMES BEACH400

0 0

4

1

3

331

1

DRIVER OF VEHICLE

0

N2 1

00. N/A01. Gunshot02. Stabbed

OFF/INC Indicator

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

TC

OD

ESA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2 3.Both

)

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Age

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____

04/16/2017

04/16/2017 04/16/2017

04/16/2017

04/16/2017

__/__/____

USA Rev. 01/21/2003

Signature of Officer Reporting

Signature of Officer Reviewing

Yes No

YYeess NNoo

C O P

Y

Type

Type

Type

Holmes Beach Police Department 20170302

N/A N/A

1

STANDARD FLORIDA TAG (Y93LZL)

ALUMINUM1 FLORIDA TAG1

N/A N/A

1

PLASTIC, TEXAS STATE ID CARD.

GOVERNMENT2 TEXAS ID CARD1

0

A 0

A

Z

8

8

00

ORANGE AND ORANGE BLOSSOM STANDARD FLORIDA TAG.

TEXAS IDENTIFICATION CARD.

0.00

0.00

PATROL331

SGT. M. PILATO

JASON HIGGINS

306

32

1

CRIMINAL TRAFFIC STATE OF FLORIDA

A

THEF

TA

DM

A. Auto Accessory/PartsB. BicycleC. Camera/Photo EquipmentD. Drug

T. TV/Video/VCRU. Currency/NegotiableV. Credit Card/Non-NegotiableW. Boat MotorX. Structure

Property Type O. Office EquipmentP. Art/CollectionQ. Computer EquipmentR. Radio/StereoS. Sports Equipment

E. Equipment/Tool. F. Food/Liquor/ConsumableG. GunH. Household Appliance/GoodsI. Plant/Citrus

J. Jewelry/Precious Metal K. Clothing/FurL. LivestockM. Musical InstrumentN. Construction Machinery

Date of Supplement

Original Date Reported Primary Offense Description Victim #1 Name (Last, First, Middle)

Agency Report Number

1. Original2. SupplementPROPERTY REPORT

Y. Farm EquipmentZ. Miscellaneous

PRO

P.D

ETA

IL/N

AR

R.

CO

DES

09. From Vehicle10. Extortion

Theft Type Codes

04. Pocket Picking05. Purse Snatching

06. Embezzlement07. From Coin Oper. Machine

08. From Public Access Building

11. By Computer12. Fraud

99. Other00. N/A01. Burglary

02. Robbery03. Shoplifting

Theft Type

A - ArresteeO - Other

1. Stolen2. Recovered

V - VictimS - Suspect

5. Lost6. Found

Person Codes Status Codes3. Stolen and Recovered4. Recovered for Other Jurisdiction

2. Criminal Mischief3. During other Offense

7. Safekeeping8. Evidence/Seized

9. Other9. OtherDamage Codes0. N/A1. Arson

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Property Stolen

PropertyRecovered

Change in PropertyStolen Value

Change in Property Recovered Value

Activity Type Unit

Activity Description Quantity Unit

P. PossessS. SellB. BuyT. Traffic

R. SmuggleD. DeliverE. UseK. Dispense/Distribute

M. Manufacture/Produce/CultivateZ. Other

A. AmphetamineB. BarbiturateC. CocaineE. Heroin

H. HallucinogenM. MarijuanaO. Opium/DerivativeP. Paraphernalia/Equipment

S. SyntheticU. UnknownZ. Other

1. Gram2. Milligram3. Kilogram4. Ounce

5. Pound6. Ton7. Liter8. Milliliter

Estimated Street Value

TOTA

LSC

OD

ESD

RU

GS

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Activity Description Quantity Unit Estimated Street Value

Activity Description Quantity Unit Estimated Street Value

AD

MIN

ISTR

ATI

VE

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reviewing

Signature of Officer Reporting

9. Dose Unit/Item

__/__/____

04/16/2017

04/16/2017

04/16/2017

__/__/____

__/__/____

__/__/____

04/16/2017

__/__/____

USA Rev. 01/21/2003

C O P

Y

Holmes Beach Police DepartmentFL0410400 20170302

1 1

01

PATROL

33

1 ACA

JASON HIGGINS

SGT. M. PILATO 306

331

I RAN FLORIDA TAG (Y93LZL) ON IN-CAR COMPUTER. THE FCIC/NCIC RETURN DISPLAYED THAT IT HAD EXPIRED01/18/2017. I INITIATED A TRAFFIC STOP ON WHITE FORD TRUCK THAT IT WAS ATTACHED TO AND MADE CONTACTWITH DRIVER, LEONARDO HERNANDEZ. HERNANDEZ SPOKE LIMITED ENGLISH AND WAS UNABLE TO PROVIDE ME WITH AFLORIDA LICENSE OR IDENTIFICATION CARD. HERNANDEZ HANDED ME A PASSPORT, AN EXPIRED TEXASIDENTIFICATION CARD, AND A MEXICAN CONSULAR PLASTIC CARD WITH UNLEGIBLE WORDING PRINTED UPON IT.HERNANDEZ ALSO COULD NOT PROVIDE INSURANCE INFORMATION. NEITHER OF HIS 2 PASSENGERS HAD FLORIDALICENSES OR SPOKE ENGLISH. I RAN HERNANDEZ THROUGH IN-CAR D.A.V.I.D. AND OTHER PROGRAMS TO OBTAINADDITIONAL INFORMATION ABOUT HIM. I WAS ABLE TO PULL UP AN ADMINISTRATION NUMBER ASSIGNED TO HIS NAMEAND IT DISPLAYED THAT HE WAS NEVER ISSUED A DRIVER'S LICENSE.

D.A.V.I.D. RETURN ALSO DISPLAYED IF DRIVER IS OWNER -- SEIZE TAG. TAG WAS PLACED INTO PROPERTY ATPOLICE DEPT. A CRIMINAL TRAFFIC TICKET WAS GIVEN TO HERNANDEZ AND I TRANSLATED COURT DATE USING ASMART PHONE SO HE COULD UNDERSTAND DATE AND TIME. HERNANDEZ WAS ALSO GIVEN 2 CIVIL INFRACTIONS. U.S.A.TOWING ARRIVED ON SCENE AND TOOK CUSTODY OF TRUCK. HERNANDEZ AND FRIENDS LEFT SCENE ON FOOT AND WENTTO THE BEACH. NO FURTHER ACTION TAKEN.

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

04/16/2017

04/16/2017

__/__/____

04/16/2017

USA Rev. 01/21/2003

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Holmes Beach Police Department FL0410400

2700

1515

01 01 01 00 00

SGT MCGOWIN5801 MARINA DR HOLMES BEACH 34217

WITNESSED BOTH VIOLATIONS

713 BLUBILL PLACE 34759KISSIMMEE

A416620888770

1515 1515 1525

32

20170305

CITY OF HOLMES BEACH

COV ALCOHOL

Sun SunSun

2 MW 1 1 0 00 0200

1

1

W 2

V 5

FL

2 NN 0 0 0 00 0000ALVAREZ NATHALIE1 2A

FW

FL

FL

6 6-3A 00005 0CCOV/ALCOHOL

___-_______

___-__-____

___ ___-____

___-__________ ___-____

___-_______863 242-4462

34217PUBLIC BEACH

GULF DR HOLMES BEACH40002 1

DEFENDANT HAD BUDWEISER LIME A RITA AND HAD A GRILL ON THE BEACH IN PUBLIC VIEW. DEFENDANT WAS CITEDFOR THE LIME A RITA AND A WARNING ON THE GRILL. SHE WAS RELEASED ON SCENE. NFI

01

PATROL

1 ACA

SGT. M. PILATOSGT. M. PILATO 306

306

1

1

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

T

00. N/A01. Gunshot02. Stabbed

CO

DES

AD

M

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 2

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

Residence Phone

Business Phone

Juvenile

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

30. Other Mobile99. Other

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

0. N/A1. Occupied

E-EscapeeZ-Other

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

Susp. #

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

# Prem. Ent.

S-SuspectA-Arrestee

Dom. Violence

Dom. Violence

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

Age

Date of Birth Age

Date of Birth Age

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

V. TypeOFF/INC Indicator

If V/W Code is V, W or CFill in this Line

1.#12.#2

3.Both

OFF/INC Indicator

If V/W Code is V, W or CFill in this Line

1.#12.#2

3.Both

Person/Unit Notified

Case Status

Time

Routed To Referred

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

1. Original2. Supplement

Juvenilein Report

JuvenileWarn/Dismiss

1

__/__/____04/16/2017

04/16/2017 04/16/2017

04/16/2017

04/16/2017__/__/____

10/17/1984

Signature of Officer Reporting

Signature of Officer Reviewing

YYeess NNoo

Yes No

12 NOFFENSE-INCIDENT REPORTGangRelated

C O P

Y

FL0410400

2700

1530

01 01 03 00 00

HERNANDEZ LORA

4505 N ROME AVE #1305 33603TAMPA

H655436931770 187201300 40

Holmes Beach Police Department1530 1532 1547

1530 1530

23

20170306

CUBAJOSE RAUL

COV/ALCOHOL

1

SunSun Sun

1 CITY OF HOLMES BEACH5801 MARINA DR HOLMES BEACH 34217

15801 MARINA DRIVE HOLMES BEACH 34217

PILATO MIKE2

2

NN

W

MW

V 5

W 2

2A

0

1

0

1

0

0

00

00

00

0000

00

FL

FL

FL

FL

01

PATROL

1 ACA

OGLINESGT. M. PILATO 306

6 6-3A 00000CCOV/ALCOHOL

708-5800941

___-__-____

___ ___-____

708-5804941___ ___-____

___-_______813 778-9735

34217ON BEACH

GULF DR HOLMES BEACH49000 0

5

1

1

322

1

PATROL SERGEANTM

SGT'S PILATO AND McGOWIN WERE ON BEACH PATROL AND OBSERVED 3 SUBJECTS CONSUMING CORONA BEER FROMBOTTLES ON A PUBLIC BEACH AT LISTED LOCATION. I ISSUED COV CITATIONS TO 2 OF THE SUBJECTS (HERNANDEZLORA AND LEON) AND SGT PILATO ISSUED GONZALEZ A COV CITATION. I TURNED ALL 3 SIGNED COV CITATIONS IN TODISPATCH FOR ENTRY INTO THE DATABASE. ALL 3 SUBJECTS WERE VERBALLY WARNED ABOUT HAVING GLASS ON THEBEACH AND I COUNSELED LEON ABOUT UNDERAGE DRINKING.

N2 1

00. N/A01. Gunshot02. Stabbed

OFF/INC Indicator

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

TC

OD

ESA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2 3.Both

)

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Age

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

Signature of Officer Reporting

Signature of Officer Reviewing By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____04/16/2017

04/16/2017 04/16/2017

04/16/2017__/__/____

04/16/2017

USA Rev. 01/23/2003

05/17/1993

Date

Yes No

YYeess NNoo

C O P

Y

Holmes Beach Police Department 20170306

2 McGOWIN5801 MARINA DR HOLMES BEACH 34217

VERN

2

6207 TADPOLE LN #201

A062595422A264620955250

33614TAMPA

20

CUBA

1106 BLANKENSHIP RD

1112479025

33527DOVER

23

COLUMBIA

LEON NATHALIE AGUIRRE

GONZALEZ SEBASTIAN MEJIA

MW

MW

W 2

1 1 0 00 0000

3 2A

2 2A

FL

FL

FL

FW

N 1

FL

708-5804941

___-__-____

___ ___-____

___-__________ ___-____

___-_______786 759-9860

___-__-_______-_______

___ ___-____

1

1

1

PATROL322

SGT. M. PILATO

OGLINE

306

COV/ALCOHOL CITY OF HOLMES BEACH

PATROL SERGEANT

CO

DES

AD

MJuvenilein Report:

Date of Supplement

Primary Offense Description

Victim Type Race

Victim Relationship To Offender

Agency Report Number

Residence Type Residence Status4. Business5. Government6. Church9. Other

SexN-N/AM-MaleF-FemaleU-Unknown

0. N/A1. City2. County

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

00. N/A01. Undetermined02. Stranger

03. Spouse04. Ex-Spouse05. Co-Habitant

06. Parent07. Brother/Sister08. Child09. Step-Parent

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

PERSON(S) REPORT

Injury Type00. N/A01. Gunshot02. Stabbed

Original Date

1. Original2. Supplement:

0. N/A1. Juvenile2. L.E. Officer3. Adult

N-N/AW-WhiteB-Black

I-American IndianO-Oriental/AsianU-Unknown

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

10. Step-Child11. In-Law12. Other Family13. Student

Victim #1 Name (Last, First, Middle)

V/W CodeV - VictimW - WitnessC - Reporting Person

O - Other

Will Victim prefer charge?

Will Victim prefer charge?

Extent of Injury

SUSP

ECT

OR

MIS

SIN

GPE

RSO

NS

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

OFF/INC Indicator V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Relationship Ethnicity

Synopsis of Involvement

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Other Contact Info. (Time Available, Interpreter, etc.)

SUSP

ECT

OR

MIS

SIN

GPE

RSO

NS

Hair Color

Suspect Code Code

Maiden Name

Occupation

Driver's License State/Number

Employer/School

Immigration and Naturalization Number Other ID. Number

Address

Place of Birth Residence Phone

Business Phone

Social Security Number

OBTS Number

Height

Complexion Facial Hair Teeth Speech/Voice Special Identifiers

Eye Color Hair Length Hair Style

Name (Last, First, Middle)

Clothing (Describe)

Last Known Address (Street, Apt. Number)

OFF/INC Indicator1.#12.#2

Sex

Nickname/Street Name

SCIC/NCIC

WeightRace

Juvenile

Build

3.Both

City

Maiden Name

Occupation

Driver's License State/Number

Employer/School

Immigration and Naturalization Number Other ID. Number

Address

Place of Birth Residence Phone

Business Phone

Social Security Number

OBTS Number

Height

Complexion Facial Hair Teeth Speech/Voice Special Identifiers

Eye Color Hair Length Hair Style

State Zip

Clothing (Describe)

Last Known Address (Street, Apt. Number)

Sex

Nickname/Street Name

SCIC/NCIC

Hair ColorWeightRace

Build

Code Name (Last, First, Middle)OFF/INC Indicator1.#12.#2

Juvenile3.Both

Susp. #

E-EscapeeM-Missing

Suspect CodeS-SuspectA-Arrestee

R-Rec. MissingZ-other

Susp. #

Age

V. Type

E-EscapeeM-Missing

S-SuspectA-Arrestee

R-Rec. MissingZ-other

Injury Type(s)

ZipStateCity

Scars/Marks/Tatoos (Location/Describe)

Scars/Marks/Tatoos (Location/Describe)

MIS

SIN

GPE

RSO

N/R

UN

AW

AY 7. Voluntary

Adult8. Unknown

1. Yes2. No8. Unknown

Incident Type 1. Runaway2. Parental3. Involuntary

Foul Play Suspected ?

1. Yes2. No

Missing Before ?

1. Yes2. No8. Unknown

1. Yes2. No8. Unknown

1. Yes2. No8. Unknown

MCIC Form Provided ? 4. Disabled5. Endangered6. Disaster Victim

Fingerprints Available? Dental Record Available

1. Yes2. No

Photo Available?

Date Last Seen Time Last Seen Accompanied By

Property Carried

Probable Destination

Medication Required/Type

ID. Type/Number

Recovery Information 7. Deceased9. Other

Doctor/Dentist (Name, Phone Number)

Transportation Mode

Location Last Seen (Address, City, St.)

5. Law Enforcement Custody6. Returned to Parent

3. Hospitalized4. HRS Custody

2. Located- Not Returned

0. N/A1. Voluntary

Name/Address

ID. Type/Number

Mental/Physical Condition

AD

MIN

ISTR

ATI

VE

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reviewing

Signature of Officer Reporting

__/__/____04/16/2017

04/16/2017

__/__/____

USA Rev. 01/23/2003

__/__/____

01/25/1997

06/17/1993Date of Birth or Age

Date of Birth or Age

YYeess NNoo

YYeess NNoo

C O P

Y

Holmes Beach Police DepartmentFL0410400 20170306

2 1

01

PATROL

1 ACA

OGLINESGT. M. PILATO 306

322

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Signature of Officer Reviewing

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

04/16/2017

04/16/2017__/__/____

04/16/2017

USA Rev. 01/23/2003

Signature of Officer Reporting

C O P

Y

FL0410400

9900

1559

1 0 2 0 0

Holmes Beach Police Department1559 1601 1616

1559 1559

20170307 COV/ALCOHOLSun

1 BICKEL1758 MALVERNM HILL CELEBRATION 34747

1141 WILDWOOD DRIVE EATONTON 31024

ROBERT STEPHEN

HOPPER JOHN DANIEL2

2

MW

W

O 3

O 33

4

1

1

0

0

00

00

00

0000

00

FL

GA

1

JASON HIGGINSSGT.COPEMAN 307

6 6-3A 00000ACOV/ALCOHOL

___-_______

___-__-____

___ ___-____

___-__________ ___-____

___-__________ ___-____

34217 W80ON BEACH

GULF DRIVE N. (BEACH) HOLMES BEACH51001

5

1

1

2

331

SGT. PILATO OBSERVED HIM CONSUMING BEER.

SGT. PILATO OBSERVED HIM CONSUMING BEER.M

N2 1

00. N/A01. Gunshot02. Stabbed

OFF/INC Indicator

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

TC

OD

ESA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair Color

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2 3.Both

)

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____04/16/2017

04/17/2017__/__/____

USA Rev. 01/23/2003

Sun Sun04/16/2017 04/16/2017

29

26

Sex Date of BirthRace Age

05/12/1990

02/17/1988

__/__/____

YYeess NNoo

YYeess NNoo

0

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Holmes Beach Police Department1 1

22

JASON HIGGINSSGT.COPEMAN 307

331

SGT. MIKE PILATO AND SGT. VERN MCGOWIN WERE ON THE SIDE-BY-SIDE BEACH PATROL VEHICLE AND OBSERVEDAFOREMENTIONED SUBJECTS CONSUMING BEER ON THE BEACH WHERE IT'S PROHIBITED. SUBJECT 1, LATER IDENTIFIEDAS ROBERT BICKEL WAS CONSUMING STELLA ARTOIS. SUBJECT 2, LATER IDENTIFIED AS JOHN HOPPER WAS CONSUMINGBUD LIGHT. BOTH SUBJECTS WERE BROUGHT TO THE 5200 BLOCK BEACH ACCESS WHERE WE GAVE THEM BOTH CITYORDINANCE TICKETS. I PHYSICALLY ISSUED SUBEJCT BICKEL HIS, AND SGT. PILATO PHYICALLY ISSUED HOPPERHIS. NO FURTHER ACTION TAKEN.

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

04/16/2017

04/17/2017__/__/____

__/__/____

USA Rev. 01/23/2003

20170307FL0410400

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

COV ALCOHOL

Holmes Beach Police DepartmentCase ReferenceA

DM

Date of Supplement Agency ORI Number

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

Agency Report Number

FL0410400 20170307

2 1

ON THIS DATE, SGT MCGOWIN AND I WERE ON BEACH PATROL WHEN I OBSERVED THE DEFENDANT (HOPPER) WITH ADARK BLUE BEER CAN IN A COOZIE. I OBSERVED THE CAN TO BE A BUD LIGHT CAN. AS WE BEGAN TO TURN AROUND,HE PUT THE BEER CAN DOWN IN FRONT OF HIM AS HE WAS SITTING AWAY FROM US. SGT MCGOWIN AND I GOT OUT TOSPEAK WITH HIM WHEN WE OBSERVED THE OTHER SUSPECT (BICKEL) WITH TWO CANS OF STELLA ARTOIS. AS I ASKEDBICKEL FOR HIS ID, I DUMPED HIS CANS AND WENT BACK TO HOPPER. I WALKED AROUND FRONT WHERE HOPPER HADHIS CAN OF BEER AT HIS FEET IN PLAIN VIEW AND PICKED IT UP AND REMOVED THE COOZIE AND DUMPED THE BEER.HOPPER WAS ARGUMENTATIVE DURING THE ENTIRE ENCOUNTER AND I ISSUED HIM A COV CITATION AND OFFICERHIGGINS ISSUED BICKEL A COV CITATION. NFI

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

01

PATROL

1 ACA

SGT. M. PILATOSGT. M. PILATO 306

306Report Contains

Arrest Number

04/16/2017__/__/____

04/16/2017

USA Rev. 01/23/2003

__/__/____

04/16/2017

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

2. No

FL0410400

2500

0109

1 1 2 0 0

SCROCCO

1205 BALLARD GREEN PLACE 33511BRANDONUNEMPLOYED N/AS620433892150

6 150

Holmes Beach Police Department0109 0600 0600

0109 0600

27

20170310

NEW YORKJONATHAN MICHAEL

POSSESSION

1

MonMon Mon

1 STATE OF FLORIDA

2 NN

MW

V 5

2A

BRO BLK

0 0 0 00 0000

FL

LT THN

FL

BORESSGT.COPEMAN 307

147 1 350B893CDRUG EQUIP-POSS

___-_______

___-__-____

___ ___-____

___-__________ ___-____

___-_______813 758-1650

S S

34217COUNTY BEACH ACCESS

GULF DR HOLMES BEACH40000 0

3

1

326

1

JEANS AND SHIRT TRACK MARKS LEFT HAND AND BOTH ARMS

N2 1

00. N/A01. Gunshot02. Stabbed

OFF/INC Indicator

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

TC

OD

ESA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2 3.Both

)

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Age

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

04/17/201704/17/2017 04/17/2017

__/__/____

04/19/2017__/__/____

__/__/____

USA Rev. 01/23/2003

06/15/1989

Signature of Officer Reviewing

Signature of Officer Reporting

SEE NARRATIVE PAGE..

Yes No

YYeess NNoo

C O P

Y

Holmes Beach Police Department 20170310

2110 CLIFTON DR. UNEMPLOYEDT642785969411

504

33594VALRICO

20 134

FLORIDATERWILLIGER SELENA ELAINE2 2A

FL

FW

N 1

HAZ BRO L SLT

FL

THN

___-_______

___-__-____

___ ___-____

___-__________ ___-____

___-__________ ___-____

___-__-_______-_______

___ ___-____

1

326

SGT.COPEMAN

BORES

307

POSSESSION STATE OF FLORIDA

JEANS AND SHIRT

CO

DES

AD

MJuvenilein Report:

Date of Supplement

Primary Offense Description

Victim Type Race

Victim Relationship To Offender

Agency Report Number

Residence Type Residence Status4. Business5. Government6. Church9. Other

SexN-N/AM-MaleF-FemaleU-Unknown

0. N/A1. City2. County

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

00. N/A01. Undetermined02. Stranger

03. Spouse04. Ex-Spouse05. Co-Habitant

06. Parent07. Brother/Sister08. Child09. Step-Parent

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

PERSON(S) REPORT

Injury Type00. N/A01. Gunshot02. Stabbed

Original Date

1. Original2. Supplement:

0. N/A1. Juvenile2. L.E. Officer3. Adult

N-N/AW-WhiteB-Black

I-American IndianO-Oriental/AsianU-Unknown

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

10. Step-Child11. In-Law12. Other Family13. Student

Victim #1 Name (Last, First, Middle)

V/W CodeV - VictimW - WitnessC - Reporting Person

O - Other

Will Victim prefer charge?

Will Victim prefer charge?

Extent of Injury

SUSP

ECT

OR

MIS

SIN

GPE

RSO

NS

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

OFF/INC Indicator V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Relationship Ethnicity

Synopsis of Involvement

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Other Contact Info. (Time Available, Interpreter, etc.)

SUSP

ECT

OR

MIS

SIN

GPE

RSO

NS

Hair Color

Suspect Code Code

Maiden Name

Occupation

Driver's License State/Number

Employer/School

Immigration and Naturalization Number Other ID. Number

Address

Place of Birth Residence Phone

Business Phone

Social Security Number

OBTS Number

Date of Birth or Age Height

Complexion Facial Hair Teeth Speech/Voice Special Identifiers

Eye Color Hair Length Hair Style

Name (Last, First, Middle)

Clothing (Describe)

Last Known Address (Street, Apt. Number)

OFF/INC Indicator1.#12.#2

Sex

Nickname/Street Name

SCIC/NCIC

WeightRace

Juvenile

Build

3.Both

City

Maiden Name

Occupation

Driver's License State/Number

Employer/School

Immigration and Naturalization Number Other ID. Number

Address

Place of Birth Residence Phone

Business Phone

Social Security Number

OBTS Number

Date of Birth Height

Complexion Facial Hair Teeth Speech/Voice Special Identifiers

Eye Color Hair Length Hair Style

State Zip

Clothing (Describe)

Last Known Address (Street, Apt. Number)

Sex

Nickname/Street Name

SCIC/NCIC

Hair ColorWeightRace

Build

Code Name (Last, First, Middle)OFF/INC Indicator1.#12.#2

Juvenile3.Both

Susp. #

E-EscapeeM-Missing

Suspect CodeS-SuspectA-Arrestee

R-Rec. MissingZ-other

Susp. #

Age

V. Type

E-EscapeeM-Missing

S-SuspectA-Arrestee

R-Rec. MissingZ-other

Injury Type(s)

ZipStateCity

Scars/Marks/Tatoos (Location/Describe)

Scars/Marks/Tatoos (Location/Describe)

MIS

SIN

GPE

RSO

N/R

UN

AW

AY 7. Voluntary

Adult8. Unknown

1. Yes2. No8. Unknown

Incident Type 1. Runaway2. Parental3. Involuntary

Foul Play Suspected ?

1. Yes2. No

Missing Before ?

1. Yes2. No8. Unknown

1. Yes2. No8. Unknown

1. Yes2. No8. Unknown

MCIC Form Provided ? 4. Disabled5. Endangered6. Disaster Victim

Fingerprints Available? Dental Record Available

1. Yes2. No

Photo Available?

Date Last Seen Time Last Seen Accompanied By

Property Carried

Probable Destination

Medication Required/Type

ID. Type/Number

Recovery Information 7. Deceased9. Other

Doctor/Dentist (Name, Phone Number)

Transportation Mode

Location Last Seen (Address, City, St.)

5. Law Enforcement Custody6. Returned to Parent

3. Hospitalized4. HRS Custody

2. Located- Not Returned

0. N/A1. Voluntary

Name/Address

ID. Type/Number

Mental/Physical Condition

AD

MIN

ISTR

ATI

VE

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reporting

__/__/____

04/19/2017

__/__/____

04/17/2017

USA Rev. 01/23/2003

__/__/____

12/01/1996

Signature of Officer Reviewing

YYeess NNoo

YYeess NNoo

C O P

Y

Type

Type

Type

Code Person

Code Person

Code Person

Code Person

Code Person

Holmes Beach Police Department 20170310

HYPODERMIC NEEDLES 8

8HYPODERMIC NEEDLES

11

1GLASS PIPE

1 GLASS PIPE1

1GLASS PIPE

1 GLASS PIPE2

16.7 GRAMS SPICE

1 SPICE2

GLASS PIPE 2SPICE 6.7

0

A

A

A

0

0

0

D

D

D

D

P 9P 9P S 1

PP

8

8

8

8

00

0.000.00

326

SGT.COPEMAN

BORES

307

1

POSSESSION STATE OF FLORIDA

A

THEF

TA

DM

A. Auto Accessory/PartsB. BicycleC. Camera/Photo EquipmentD. Drug

T. TV/Video/VCRU. Currency/NegotiableV. Credit Card/Non-NegotiableW. Boat MotorX. Structure

Property Type O. Office EquipmentP. Art/CollectionQ. Computer EquipmentR. Radio/StereoS. Sports Equipment

E. Equipment/Tool. F. Food/Liquor/ConsumableG. GunH. Household Appliance/GoodsI. Plant/Citrus

J. Jewelry/Precious Metal K. Clothing/FurL. LivestockM. Musical InstrumentN. Construction Machinery

Date of Supplement

Original Date Reported Primary Offense Description Victim #1 Name (Last, First, Middle)

Agency Report Number

1. Original2. SupplementPROPERTY REPORT

Y. Farm EquipmentZ. Miscellaneous

PRO

P.D

ETA

IL/N

AR

R.

CO

DES

09. From Vehicle10. Extortion

Theft Type Codes

04. Pocket Picking05. Purse Snatching

06. Embezzlement07. From Coin Oper. Machine

08. From Public Access Building

11. By Computer12. Fraud

99. Other00. N/A01. Burglary

02. Robbery03. Shoplifting

Theft Type

A - ArresteeO - Other

1. Stolen2. Recovered

V - VictimS - Suspect

5. Lost6. Found

Person Codes Status Codes3. Stolen and Recovered4. Recovered for Other Jurisdiction

2. Criminal Mischief3. During other Offense

7. Safekeeping8. Evidence/Seized

9. Other9. OtherDamage Codes0. N/A1. Arson

PRO

PER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Property Stolen

PropertyRecovered

Change in PropertyStolen Value

Change in Property Recovered Value

Activity Type Unit

Activity Description Quantity Unit

P. PossessS. SellB. BuyT. Traffic

R. SmuggleD. DeliverE. UseK. Dispense/Distribute

M. Manufacture/Produce/CultivateZ. Other

A. AmphetamineB. BarbiturateC. CocaineE. Heroin

H. HallucinogenM. MarijuanaO. Opium/DerivativeP. Paraphernalia/Equipment

S. SyntheticU. UnknownZ. Other

1. Gram2. Milligram3. Kilogram4. Ounce

5. Pound6. Ton7. Liter8. Milliliter

Estimated Street Value

TOTA

LSC

OD

ESD

RU

GS

PRO

PER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PRO

PER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PRO

PER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PRO

PER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Activity Description Quantity Unit Estimated Street Value

Activity Description Quantity Unit Estimated Street Value

AD

MIN

ISTR

ATI

VE

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reviewing

Signature of Officer Reporting

9. Dose Unit/Item

__/__/____

04/17/2017

__/__/____

__/__/____

__/__/____

__/__/____

__/__/____

04/19/2017

__/__/____

USA Rev. 01/23/2003

C O P

Y

AD

M

1100.. OOtthheerr -- SSppeecc..66.. TTrraannss..

77.. EEnnggiinnee PPaarrttss

1. Key

11.. KKeeyy

3. Hot Wire

6. Trans.

7. Engine Parts

8. Major Body Parts

VEH

ICLE

/VES

SEL

1. Original2. Supplement

Date of Supplement

Reg. State

Date Recovered

LengthVessel Name

StyleModelStatusPerson #

1. Local / Local2. Local / Other3. Other / Local

Tag Type

Primary Offense Description Victim #1 Name (Last, First, Middle)

Person Code Status Code Damage Code Type Recovery Location Recovery Code Stolen / Recovered

Holmes Beach Police Department

1. Stolen2. Recovered3. Stolen and Recovered4. Suspicious

5. Impounded6. Abandoned7. Fail Return8. Seized9. Other

0. N / A1. Arson2. Criminal Mischief3. During Other Offense

1. Auto2. Truck / Van3. Motorcycle4. Camper / RV5. Bus

6. Trailer7. Boat8. Aircraft9. Other

VEHICLE REPORT

Original Date Reported

Agency Report Number

Description (Identifying Characteristics, Noticeable Damage, Interior Color, etc)

Tag Reg./Doc. # Reg. Year Decal Number

VIN/Hull/FAA Estimated Value

Propulsion

Insurance Company Lien HolderCondition

Hull Material Boat Type

Recovery Address/Geographic Indicator

Recovery Loc. Recovery Code Original Reporting Agency Report Number Reason/Authority

SCIC/NCIC Location of Original Theft

Value Recovered

1. Window Closed

ESPD755NPDH4AE2EH495100 $5,000

2. Locked 3. Keys in Ignition

RED Color (Top/Bottom)

Towed By

Components Stripped

0. N/A 5. Interior 9. Tag/Decal Stolen

10. Other - Spec.0. N/A 8. Unk.2. Tow Truck 4. Steering

5. Ignition 1. VIN Plt.

4. Battery

Person Code Damage Type Year Make

2014 HYUNDA 4DR 4DR

Storage Location

V- VictimS- SuspectA- ArresteeO- Other

5. Park / Playground6. Shopping Mall7. Woods8. Water9. Other

1. Family Residence2. Apt. Complex3. Housing Project4. Commercial / Industrial

4. Stripped / Theft From9. Other

CO

DES

VEH

ICLE

/VES

SEL

VEH

ICLE

INV.

/NA

RR

ATI

VE

Person Code Person # Status Damage StyleModelType Year Make

Reg. State Tag TypeTag Reg./Doc. # Reg. Year Decal Number

VIN/Hull/FAA Estimated Value

Insurance Company Lien HolderCondition 1. Window Closed 1. Window Closed 2. Locked 2. Locked 3. Keys in Ignition 3. Keys in Ignition

Description (Identifying Characteristics, Noticeable Damage, Interior Color, etc) Color (Top/Bottom)

LengthVessel Name PropulsionHull Material Boat Type

Date RecoveredRecovery Address/Geographic Indicator Value Recovered

Recovery Loc. Recovery Code Original Reporting Agency Report Number Reason/Authority

Methodof Theft

00.. NN//AA 88.. UUnnkk..22.. TTooww TTrruucckk

33.. HHoott WWiirree

44.. SStteeeerriinngg

55.. IIggnniittiioonn

Components Stripped

00.. NN//AA 55.. IInntteerriioorr

88.. MMaajjoorr BBooddyy PPaarrttss

99.. TTaagg//DDeeccaall SSttoolleenn11.. VVIINN PPlltt..

44.. BBaatttteerryy

Location of Original TheftTowed By Storage Location SCIC/NCIC

Vehicle #

HoldY - YesN - No

HoldY - YesN - No

Vehicle #

Methodof Theft

2. Tires/Wheels

3. Radio/CB

22.. TTiirreess//WWhheeeellss

33.. RRaaddiioo//CCBB

FL

Case Status

Routed To Referred To

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

BORESSGT.COPEMAN 307

326

Arrest Number

20170310POSSESSION STATE OF FLORIDA

11 09A 1

1

2017

__/__/____

__/__/____

04/19/2017__/__/____

__/__/____

USA Rev. 01/21/2003

__/__/____

04/17/2017

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

AD

M

Holmes Beach Police Department

POSSESSION

FL0410400 20170310

2 1

BORESSGT.COPEMAN 307

326

ON 04/17/2017 AT 01:09HRS I WAS ON PATROL IN THE PARKING LOT AT 4000 GULF DR.(COUNTY BEACH ACCESS). WHILE ON PATROL I NOTICED A RED HYUNDAI 4DR PARKED INTHE PARKING LOT. I PULLED UP BEHIND THE RED HYUNDAI BEARING FLORIDAREGISTRATION (FL,ESPD75).

I APPROACHED THE RED HYUNDAI ON THE DRIVER'S SIDE AND OBSERVED THE DRIVER WASPASSED OUT BEHIND THE WHEEL. THE KEYS WERE IN THE IGNITION AND THE VEHICLE WASRUNNING AND THE DRIVER HAD FULL CONTROL OF THE VEHICLE. I NOTICED THAT THEREWAS A WHITE FEMALE ALSO PASSED OUT IN THE PASSENGER SEAT. THE PASSENGER WASHOLDING A CLEAR PLASTIC BAG WITH A GREEN LEAFY SUBSTANCE AND A GLASS PIPE.(PHOTO WAS TAKEN AND ATTACHED). I MADE CONTACT WITH THE DRIVER WHO WASIDENTFIED AS JONATHAN M. SCROCCO BY HIS FLORIDA DL (S620433892150). I ADVISED HIMTHAT THE PARK WAS CLOSED AT 10PM AND HE WAS NOT ALOUD TO BE HERE. AS I WASCOMMUNICATING WITH MR. SCROCCO I OBSERVED FRESH TRACK MARKS ON HIS LEFTHAND.

I APPROACHED THE PASSENGER SIDE AND MADE CONTACT WITH THE WHITE FEMALE WHOWAS IDENTIFIED AS SELENA E. TERWILLIGER BY HER FLORIDA DL (T642785969411) AND HERSTEP OUT OF THE VEHICLE. AS I MADE CONTACT WITH HER SHE WAS ATTEMPTING TO HIDETHE CLEAR PLASTIC BAG AND PIPE BETWEEN HER LEGS. MS. TERWILLIGER STATED THATTHE GREEN LEAFY SUBSTANCE WAS “SPICE”. I PLACED MS. TERWILLIGER IN CUSTODY ANDPLACED HER IN THE REAR OF MY PATROL VEHICLE. I ASKED MR. SCROCCO TO STEP OUT OFTHE VEHICLE AND WALK TO THE FRONT OF MY PATROL VEHICLE FOR SFST'S. MR. SCROCCOAGREED TO PARTICIPATE IN SFST'S.

AFTER PARTICIPATING IN SFST'S I ASKED MR. SCROCCO IF HE HAD ANY CONTRABAND INTHE VEHICLE. MR. SCROCCO GAVE CONSENT TO SEARCH THE VEHICLE. I LOCATED EIGHTHYPODERMIC NEEDLES IN THE TRUNK WHICH HAD FLUID INSIDE. I FURTHER LOCATED AGLASS PIPE, AND CLEAR PLASTIC BAG WITH WHITE RESIDUE INSIDE. I ALSO LOCATED ANOPEN VODKA BOTTEL BEHIND THE REAR PASSENGER SEAT. MR. SCROCCO WAS PLACEDINTO CUSTODY.

I LATER TRANSPORTED BOTH MR. SCROCCO AND MS. TERWILLIGER TO MCSO JAIL.

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

Case Reference

Date of Supplement Agency ORI Number Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

04/17/2017

04/19/2017__/__/____

__/__/____

USA Rev. 01/23/2003

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

2312/11/1993

FL0410400

27

00

0109

01 01 01 00 00

MACNEEL

929 GILMORE AVE 33801LAKELAND

HOSTESS WINGHOUSE

M254104939510

508 120

Holmes Beach Police Department

0109 0109 0530

20170311

FLORIDA

COURTNEY D

DRUGS

01

Mon

Mon Mon

01 STATE OF FLORIDA

2 NN

FW

V 5

2A

BRO BLN

0 0 0 00 0000

FL

MED THN

FL

02

PATROL

1 ACA

WALKER

SGT. M. PILATO 306

13 6B 350A

147 1 350BADRUG EQUIP-POSS

893

893

ADRUG LT 20 GRAM

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

813 285-8019

L S

34217GULF DRIVE HOLMES BEACH4000

0 0

3

3

1

312

1

N2 1

00. N/A01. Gunshot02. Stabbed

OFF/INC Indicator

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

TC

OD

ESA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2 3.Both

)

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Age

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____

04/17/2017

04/17/2017 04/17/2017

04/17/2017

04/17/2017

__/__/____

USA Rev. 01/21/2003

Signature of Officer Reporting

Signature of Officer Reviewing

Yes No

YYeess NNoo

C O P

Y

Type

Type

Type

Holmes Beach Police Department 20170311

MARIJUANA 3.9

1

CANNABIS GRINDER

1 GRINDER01

1

CANNABIS

1 CANNABIS01

$5

$0

0

A 0

D

D

P 1M

5.00

1.00

8

8

00

0.00

6.00

PATROL312

SGT. M. PILATO

WALKER

306

1

DRUGS STATE OF FLORIDA

A

THEF

TA

DM

A. Auto Accessory/PartsB. BicycleC. Camera/Photo EquipmentD. Drug

T. TV/Video/VCRU. Currency/NegotiableV. Credit Card/Non-NegotiableW. Boat MotorX. Structure

Property Type O. Office EquipmentP. Art/CollectionQ. Computer EquipmentR. Radio/StereoS. Sports Equipment

E. Equipment/Tool. F. Food/Liquor/ConsumableG. GunH. Household Appliance/GoodsI. Plant/Citrus

J. Jewelry/Precious Metal K. Clothing/FurL. LivestockM. Musical InstrumentN. Construction Machinery

Date of Supplement

Original Date Reported Primary Offense Description Victim #1 Name (Last, First, Middle)

Agency Report Number

1. Original2. SupplementPROPERTY REPORT

Y. Farm EquipmentZ. Miscellaneous

PRO

P.D

ETA

IL/N

AR

R.

CO

DES

09. From Vehicle10. Extortion

Theft Type Codes

04. Pocket Picking05. Purse Snatching

06. Embezzlement07. From Coin Oper. Machine

08. From Public Access Building

11. By Computer12. Fraud

99. Other00. N/A01. Burglary

02. Robbery03. Shoplifting

Theft Type

A - ArresteeO - Other

1. Stolen2. Recovered

V - VictimS - Suspect

5. Lost6. Found

Person Codes Status Codes3. Stolen and Recovered4. Recovered for Other Jurisdiction

2. Criminal Mischief3. During other Offense

7. Safekeeping8. Evidence/Seized

9. Other9. OtherDamage Codes0. N/A1. Arson

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Property Stolen

PropertyRecovered

Change in PropertyStolen Value

Change in Property Recovered Value

Activity Type Unit

Activity Description Quantity Unit

P. PossessS. SellB. BuyT. Traffic

R. SmuggleD. DeliverE. UseK. Dispense/Distribute

M. Manufacture/Produce/CultivateZ. Other

A. AmphetamineB. BarbiturateC. CocaineE. Heroin

H. HallucinogenM. MarijuanaO. Opium/DerivativeP. Paraphernalia/Equipment

S. SyntheticU. UnknownZ. Other

1. Gram2. Milligram3. Kilogram4. Ounce

5. Pound6. Ton7. Liter8. Milliliter

Estimated Street Value

TOTA

LSC

OD

ESD

RU

GS

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Activity Description Quantity Unit Estimated Street Value

Activity Description Quantity Unit Estimated Street Value

AD

MIN

ISTR

ATI

VE

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reviewing

Signature of Officer Reporting

9. Dose Unit/Item

__/__/____

04/17/2017

04/17/2017

04/17/2017

__/__/____

__/__/____

__/__/____

04/17/2017

__/__/____

USA Rev. 01/21/2003

C O P

Y

Holmes Beach Police Department

20170310

FL0410400 20170311

1 1

02

PATROL

1 ACA

WALKER

SGT. M. PILATO 306

312

ON 04/17/2017, AT 0109 HOURS, I RESPONDED AS A BACK UP OFFICER TO 4000 GULF DRIVE, IN REFERENCE TO 4SUSPICIOUS VEHICLES. UPON ARRIVAL I OBSERVED A BLACK SUV BEARING FLORIDA TAG (#DRRX36) WHICH WASPARKED IN THE CLOSED COUNTY PARK. I THEN SPOKE WITH THE DRIVER COURTNEY MACNEEL, WHO APPEARED TO BENERVOUS. I COULD SMELL THE ODOR OF BURNT CANNABIS EMITTING FROM THE VEHICLE. I ASKED MACNEEL IF THEREWAS ANYTHING ILLEGAL INSIDE THE VEHICLE TO WHICH SHE REPLIED "NO". I THEN ASKED IF SHE MINDED IF ICHECKED. SHE STATED "YES", I COULD DO WHAT I NEEDED TO DO. UPON SEARCHING THE FRONT DRIVERS SIDE, IOBSERVED A SILVER OBJECT WHICH APPEARED TO BE A MARIJUANA GRINDER. UPON OPENING IT, I OBSERVED A GREENLEAFY SUBSTANCE, WHICH FIELD TESTED POSITIVE FOR MARIJUANA. I THEN OBSERVED A CIGARETTE BOX IN THECENTER CONSOLE. UPON OPENING THE BOX, I OBSERVED 3 BURNT MARIJUANA CIGARETTES. I ISSUED MACNEEL ANOTICE TO APPEAR FOR POSSESSION OF CANNABIS(LESS THAT 20 GRAMS), AND POSSESSION OF DRUG PARAPHERNALIA.I TOOK PICTURES OF THE EVIDENCE AND PLACED IT INTO THE HOLMES BEACH POLICE DEPARTMENTS EVIDENCE LOCKERNUMBER 2.

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

04/17/2017

04/17/2017

__/__/____

04/17/2017

USA Rev. 01/21/2003

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

506FW 4507/30/1971 GRN BLN

FL0410400

0100

0026

01 01 01 00 00

KIER

193 KEMP DR 14502MACEDON

972872612

Holmes Beach Police Department0026 0034 0102

20170314

STEPHANIE L

COV/NOISE

1

Tue

01 ANONYMOUS203 73RD ST HOLMES BEACH 34217

2 UU

V 3

2A

0 0 0 00 0000

FL

NY

NY

PATROLC.LABRANCHE

SGT. M. PILATO 306CODE

0 0 00000CCOV/NOISE

___-_______

___-__-____

813 241-5368

___-__________ ___-____

___-_______585 420-8219

3421772ND ST HOLMES BEACH2040

5

1

318

1

UNITS RESPONDED TO 703 73RD ST REGARDING A COMPLAINT OF LOUD TALKING COMING FROM BEHIND THAT RESIDENCE.I ARRIVED AND COULD HEAR SOME SHOUTING FROM THE ROADWAY. I COULD HEAR MUSIC, LOUD TALKING, LAUGHING ANDOCCASIONAL SHOUTING COMING FROM THE SOUTH EAST CORNER OF THE CALLER'S BACKYARD WHICH WAS ADJACENT TOTHE NOISE SOURCE. THE dB READING FROM THIS AREA WAS AT 55dB PEAKING AT 67dB. WHILE INVESTIGATING THISCOMPLAINT, A SECOND NOISE COMPLAINT FROM AN ANONYMOUS MALE ADVISING LOUD NOISE IN THE SAME AREA. ILOCATED THE SOURCE OF THE NOISE AT 204 72ND ST. KIER ADVISED SHE WAS IN CHARGE OF THE RENTAL PROPERTYAND WAS ISSUED A COV CITATION FOR NOISE.

N2 1

00. N/A01. Gunshot02. Stabbed

OFF/INC Indicator

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

TC

OD

ESA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair Color

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2 3.Both

)

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____04/18/2017

04/18/2017__/__/____

USA Rev. 01/23/2003

Tue Tue04/18/2017 04/18/2017

00

Sex Date of BirthRace Age

__/__/____

Yes No

YYeess NNoo

0

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Holmes Beach Police Department

COV/NOISE

2 1

CODEPATROL

C.LABRANCHESGT. M. PILATO 306

318

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

04/18/2017

04/18/2017__/__/____

__/__/____

USA Rev. 01/23/2003

20170314FL0410400

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

509MW 3211/27/1984 BRO BLK S S

FL0410400

26

00

0743

01 01 01 00 00

BRUNO VASQUEZ

608 22ND PL E 34208BRADENTON

PREMIUM PAINTERS

B-651-720-84-427-0

Holmes Beach Police Department

0743 0743 0835

20170315

MEXICO

RAFAEL

DRIVERS LICENSE

01

Tue

01 STATE OF FLORIDA

2 NN

V 0

2A

0 0 0 00 0000

FL

MED THN

FL

01

PATROL

1 ACA

J. PIERCE

SGT. M. PILATO 306

03 1 9000

02 1 9000CVEHICLE

322

320

CDRIVERS LIC

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

34217MARINA DR HOLMES BEACH5400

0

4

4

1

309

3

N2 1

00. N/A01. Gunshot02. Stabbed

OFF/INC Indicator

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

TC

OD

ESA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair Color

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2 3.Both

)

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____

04/18/2017

04/18/2017

__/__/____

USA Rev. 01/23/2003

Tue Tue04/18/2017 04/18/2017

Sex Date of BirthRace Age

04/18/2017

Yes No

YYeess NNoo

0

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Holmes Beach Police Department

NO DL NO MOTO REG

2 1

01

PATROL

1 ACA

J. PIERCE

SGT. M. PILATO 306

309

ON 04-18-17 WHILE OBSERVING TRAFFIC I OBSERVED A GREY LINCOLN TOWN CAR BEARING FL TAG #DAZR82TRAVELING NORTH ON GULF DR. UPON RUNNING THE TAG THROUGH FCIC/NCIC IT RETURNED ON A RED FORD STATIONWAGON. I CONDUCTED A TRAFFIC STOP ON THE VEHICLE AT THE 5400 BLOCK OF MARINA DR. UPON SPEAKING WITHTHE DRIVER (RAFAEL BRUNO VASQUEZ) HE DID NOT HAVE A DRIVERS LICENSE AND HANDED ME A MEXICAN ID CARD.HE IS NOT A US CITIZEN AND STATED HE WORKED FOR PREMIUM PAINTERS. UPON RUNNING THEVIN#1LNLM82W4SY657370(IL) THROUGH FCIC/NCIC IT SHOWED EXPIRED 09-15-15. SGT PILATO SPOKE WITH THEGIRLFRIEND OF (RAFAEL BRUNO VASQUEZ). SHE HELPED TRANSLATE OVER THE PHONE THAT HE PUT THE LICENSEPLATE FROM THEIR OTHER VEHICLE ON THIS ONE AND THEY BOUGHT IT BUT HAD NOT REGISTERED IT YET. THERE WASALSO NO INSURANCE ON THIS VEHICLE. I VERIFIED (RAFAEL BRUNO VASQUEZ) IDENTITY AND ISSUED HIM NOTICESTO APPEAR FOR NO VLID DL AND OPERATING AN UNREGISTERED MOTOR VEHICLE. ELMERS RESPONDED (ROTATION) TORETRIEVE THE VEHICLE.

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

04/18/2017

04/18/2017

__/__/____

04/18/2017

USA Rev. 01/23/2003

20170315FL0410400

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

2912/03/1987

FL0410400

25

00

0938

01 01 01 00 00

CONTRERAS CEJA

611 22ND PL E UNIT 212 34208BRADENTON

PANTER PREMIER PAINTER

C-536-060-87-943-0

502 140

Holmes Beach Police Department

0938 0938 1148

20170316

MEXICO

BERENICE

DRIVERS LICENSE

01

Tue

Tue Tue

01 STATE OF FLORIDA

2 NN

FW

V 0

2A

BRO BLK

0 0 0 00 0000

FL

MED THN

FL

01

PATROL

1 ACA

J. PIERCE

SGT. M. PILATO 306

34 5 9000

02 1 9000CVEHICLE

322

320

CDRIVERS LIC

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

M S

34217EAST BAY DR HOLMES BEACH3260

0 0

4

1

1

309

1

TATTOO HAND GRIM REAPER

N2 1

00. N/A01. Gunshot02. Stabbed

OFF/INC Indicator

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

TC

OD

ESA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2 3.Both

)

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Age

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____

04/18/2017

04/18/2017 04/18/2017

04/18/2017

04/18/2017

__/__/____

USA Rev. 01/21/2003

Signature of Officer Reporting

Signature of Officer Reviewing

Yes No

YYeess NNoo

C O P

Y

Type

Type

Type

Holmes Beach Police Department 20170316

1

FL TAG 477NJS

1 FL TAG #477NJS01 0 Z8

00

FL TAG #477NJS

0.00

0.00

PATROL309

SGT. M. PILATO

J. PIERCE

306

1

DRIVERS LICENSE STATE OF FLORIDA

A

THEF

TA

DM

A. Auto Accessory/PartsB. BicycleC. Camera/Photo EquipmentD. Drug

T. TV/Video/VCRU. Currency/NegotiableV. Credit Card/Non-NegotiableW. Boat MotorX. Structure

Property Type O. Office EquipmentP. Art/CollectionQ. Computer EquipmentR. Radio/StereoS. Sports Equipment

E. Equipment/Tool. F. Food/Liquor/ConsumableG. GunH. Household Appliance/GoodsI. Plant/Citrus

J. Jewelry/Precious Metal K. Clothing/FurL. LivestockM. Musical InstrumentN. Construction Machinery

Date of Supplement

Original Date Reported Primary Offense Description Victim #1 Name (Last, First, Middle)

Agency Report Number

1. Original2. SupplementPROPERTY REPORT

Y. Farm EquipmentZ. Miscellaneous

PRO

P.D

ETA

IL/N

AR

R.

CO

DES

09. From Vehicle10. Extortion

Theft Type Codes

04. Pocket Picking05. Purse Snatching

06. Embezzlement07. From Coin Oper. Machine

08. From Public Access Building

11. By Computer12. Fraud

99. Other00. N/A01. Burglary

02. Robbery03. Shoplifting

Theft Type

A - ArresteeO - Other

1. Stolen2. Recovered

V - VictimS - Suspect

5. Lost6. Found

Person Codes Status Codes3. Stolen and Recovered4. Recovered for Other Jurisdiction

2. Criminal Mischief3. During other Offense

7. Safekeeping8. Evidence/Seized

9. Other9. OtherDamage Codes0. N/A1. Arson

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Property Stolen

PropertyRecovered

Change in PropertyStolen Value

Change in Property Recovered Value

Activity Type Unit

Activity Description Quantity Unit

P. PossessS. SellB. BuyT. Traffic

R. SmuggleD. DeliverE. UseK. Dispense/Distribute

M. Manufacture/Produce/CultivateZ. Other

A. AmphetamineB. BarbiturateC. CocaineE. Heroin

H. HallucinogenM. MarijuanaO. Opium/DerivativeP. Paraphernalia/Equipment

S. SyntheticU. UnknownZ. Other

1. Gram2. Milligram3. Kilogram4. Ounce

5. Pound6. Ton7. Liter8. Milliliter

Estimated Street Value

TOTA

LSC

OD

ESD

RU

GS

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PRO

PER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Activity Description Quantity Unit Estimated Street Value

Activity Description Quantity Unit Estimated Street Value

AD

MIN

ISTR

ATI

VE

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reviewing

Signature of Officer Reporting

9. Dose Unit/Item

__/__/____

04/18/2017

__/__/____

__/__/____

__/__/____

__/__/____

__/__/____

04/18/2017

__/__/____

USA Rev. 01/21/2003

C O P

Y

Holmes Beach Police Department

DRIVERS LICENSE

FL0410400 20170316

2 1

01

PATROL

1 ACA

J. PIERCE

SGT. M. PILATO 306

309

ON 04-18-17 WHILE ON ROUTINE PATROL I OBSERVED A WHITE HONDA CIVIC BEARING FL TAG #477NJS IN THEPARKING LOT IN FRONT OF THE DOLLAR TREE. THE VEHICLE WAS OCCUPIED BY A FEMALE. UPON RUNNING THE TAGTHROUGH FCIC/NCIC IT RETURNED AS NOT REGISTERED AND HAD EXPIRED AS OF 12-20-12. IT DID NOT BELONG ONTHE VEHICLE. THE EXPIRATION STICKER ON THE PLATE WAS ALSO IMPROPER AND READ 11-16. I NOTIFIED SGTPILATO OF THE VEHICLE AND UPON SEEING IT LEAVE THE AREA I CONDUCTED A TRAFFIC STOP ON IT AS ITTRAVELED SOUTH THROUGH THE PLAZA. THE FEMALE DRIVER (BERENICE,,CONTRERAS CEJA) HANDED ME HER PASSPORTAND STATED SHE DID NOT HAVE A DRIVERS LICENSE. UPON RUNNING HER LICENSE THROUGH FCIC/NCIC SHE WASSUSPENDED AS OF:01/29/2013 CANC-INDEF DL EXPIRED-F.S. 322.08 (6)06/09/2009 REV-60.0 MOS HABITUAL TRAFFIC VIOLATOR10/26/2016 REV-60.0 MOS HABITUAL TRAFFIC VIOLATOR10/26/2016 FR-SUSP SR-26 RECEIVEDTHE VIN# 1HGES16542L028895 OF THE HONDA SHOWED IT AS UNREGISTERED. THE DEFENDANT ALSO HAD 5 PRIOR DWLSCONVICTIONS. I PLACED HER IN HANDCUFFS FOR DRIVING ON A REVOKED LICENSE AS A HABITUAL TRAFFIC OFFENDERAND OPERATING AN UNREGISTERED MOTOR VEHICLE. HER HUSBAND RESPONDED TO RETRIEVE HER BELONGINGS. MATT'SEXPRESS RESPONDED (ROTATION) TO RETRIEVE THE UNREGISTERED MOTOR VEHICLE. I TRANSPORTED (BERENICE,,CONTRERAS CEJA) TO THE STATION TO COMPLETE PAPERWORK. UPON COMPLETING PAPERWORK I DELIVERED HER TOMCSO TRANSPORT AT 75TH ST AND MANATEE WITHOUT INCIDENT.CITATIONS: A2H5LSE A2H5LTETHE LICENSE PLATE WAS PLACED IN PROPERTY AS SEIZED TO BE TURNED OVER TO DHSMV.

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

04/18/2017

04/18/2017

__/__/____

04/18/2017

USA Rev. 01/21/2003

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

411FW 5912/05/1957

FL0410400

0300

1343

01 00 01 00 00

COBLENTZ

308 60TH ST 34217HOLMES BEACH

C145110579450

Holmes Beach Police Department1343 1343 1449

20170317

CHERYL JEAN

BAKER ACT

01

Tue

01 COBLENTZ308 60TH ST HOLMES BEACH 34217

LUCAS MICHAEL TRENTAL

2 MW

C 3

2A

1 1 0 00 0000

FL

FL

LT THN

FL

PATROLJ. PIERCE

SGT. M. PILATO 306

467 9000394CBAKER ACT

___-_______

___-__-____

___ ___-____

___-__________ ___-____

___-__________ ___-____

3421760TH ST HOLMES BEACH3080

9

1

309

1

N2 1

00. N/A01. Gunshot02. Stabbed

OFF/INC Indicator

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

TC

OD

ESA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair Color

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2 3.Both

)

If V/W Code is V, W or CFill in this Line

OFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code is V, W or CFill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____04/18/2017

04/18/2017__/__/____

USA Rev. 01/23/2003

Tue Tue04/18/2017 04/18/2017

18

Sex Date of BirthRace Age

10/09/1998

__/__/____

YYeess NNoo

YYeess NNoo

0

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Holmes Beach Police Department

BAKER ACT

1 1

PATROLJ. PIERCE

SGT. M. PILATO 306309

ON 04-18-17 I RESPONDED TO 308 60TH ST IN REFERENCE TO A POSSIBLE DOMESTIC RELATED BAKER ACTSITUATION. UPON ARRIVAL I OBSERVED (CHERYL JEAN COBLENTZ) THROWING FURNITURE FROM THE BALCONY OF THERESIDENCE. THE COMPLAINANT(LUCAS COBLENTZ)WALKED UP TO THE SCENE. LUCAS COBLENTZ ADVISED HIS MOTHERHAS GONE CRAZY AND HAD THROWN HIS GUITAR CASE AND BROKE IT AND ALSO TAKEN HIS DOOR FROM THE HINGES ANDTHROWN IT OUTSIDE OFF THE BALCONY AND BROKEN IT. UPON TRYING TO MAKE CONTACT WITH CHERYL COBLENTZ SHELOCKED THE DOOR ON ME AND WENT INSIDE THE RESIDENCE. SHE THEN WALKED OUT THE BACK DOOR WHERE SGTPILATO WAS. ONCE ESTABLISHING THAT THE DOOR WAS HER SONS PROPERTY AND THE GUITAR CASE SHE DESTROYEDWAS ALSO HIS AND THAT LUCAS WANTED TO PURSUE CHARGES, SGT PILATO AND I PLACED CHERYL COBLENTZ INHANDCUFFS (DOUBLE LOCKED). SHE ACTIVELY RESISTED THE ENTIRE TIME AND HAD TO BE WALKED OUT TO THE FRONTYARD AND THEN FAKED THAT SHE PASSED OUT IN THE ROADWAY. SGT PILATO THEN NOTIFIED EMS AND THEYRESPONDED TO THE SCENE TO CHECK ON HER. UPON SECOND INTERVIEW WITH HER SON LUCAS HE ADVISED THAT HEWALKED INTO THE HOUSE AND FOUND HIS MOTHER CUTTING HERSELF WITH GLASS. CHERYL HAD CUTS ALL OVER HERARM AND THERE WAS BLOOD IN THE HOUSE. UPON EMS ARRIVAL I ADVISED THAT COBLENTZ WOULD BE PLACED UNDER ABAKER ACT. I FOLLOWED EMS TO THE HOSPITAL AND FILLED OUT THE PAPER WORK FOR THE BAKER ACT AS COBLENTZWAS IN FACT A DANGER TO HERSELF.

NA

RR

ATI

VE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense2. Arrest

JuvenileWarn/Dismiss

1. Original2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

04/18/2017

04/18/2017__/__/____

__/__/____

USA Rev. 01/23/2003

20170317FL0410400

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

Holmes Beach Police Department FL0410400

08

00

0041

01 00 00 00 00

CARTER

201 HARVERKOS CT UNIT A HOLMES BEACH 34217

0041 0041 0203

20170319

CRISTIN MARIE

MARCHMAN

Wed Wed

Wed

2 FW 1 1 0 00 0000

01O 3

FL

0 0 00009 0AMARCHMAN ACT

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

34217MARINA DRIVE HOLMES BEACH5410

0 0

ON 04/19/2017, I WAS DISPATCHED TO 5410 MARINA DRIVE, IN REFERENCE TO AN ASSIST EMS WITH A UNCONSCIOUSFEMALE. UPON ARRIVAL I OBSERVED THE SUBJECT PASSED OUT AT A BOOTH. I ATTEMPTED SEVERAL TIMES TO WAKEHER UP BUT WAS UNSUCCESSFUL. I THEN LAID THE FEMALE ON THE GROUND AND WAITED FROM EMS. WE ATTEMPTED TOCONTACT SOMEONE TO TAKE RESPONSIBILITY FOR HER BUT WERE UNABLE TO MAKE CONTACT. DUE TO HER BEINGEXTREMELY INTOXICATED AND NOT HAVING ANYONE TO CARE FOR HER I COMPLETED A MARCHMAN ACT FORM AND EMSTRANSPORTED HER TO BLAKE. I ALSO RESPONDED TO BLAKE AND TURNED IN MY PAPERWORK. I FELT THE SUBJECTWOULD BE UNABLE TO CARE FOR HERSELF IF LEFT UNATTENDED.

WALKER

SGT.COPEMAN 307

312

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

T

00. N/A01. Gunshot02. Stabbed

CO

DES

AD

M

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 2

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

Residence Phone

Business Phone

Juvenile

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

30. Other Mobile99. Other

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

0. N/A1. Occupied

E-EscapeeZ-Other

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

Susp. #

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

# Prem. Ent.

S-SuspectA-Arrestee

Dom. Violence

Dom. Violence

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

Age

Date of Birth Age

Date of Birth Age

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

V. TypeOFF/INC Indicator

If V/W Code is V, W or CFill in this Line

1.#12.#2

3.Both

OFF/INC Indicator

If V/W Code is V, W or CFill in this Line

1.#12.#2

3.Both

Person/Unit Notified

Case Status

Time

Routed To Referred

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

1. Original2. Supplement

Juvenilein Report

JuvenileWarn/Dismiss

1

36

__/__/____

04/19/2017

04/19/2017 04/19/2017

__/__/____

04/19/2017

__/__/____

05/07/1980

Signature of Officer Reporting

Signature of Officer Reviewing

YYeess NNoo

YYeess NNoo

12 NOFFENSE-INCIDENT REPORTGangRelated

C O P

Y

Holmes Beach Police Department FL0410400

2600

1900

1 1 1 0 0

CITY OF HOLMES BEACH

2358 E HAYES ST 34453IVERNESSLABORER IMGS400555753410SHORTS AND TEE SHIRT

510 200

1900 1900 19301900 1930

41

20170324 COV ALCOHOL

Wed WedWed

2 NN 0 0 0 00 0000

1V 5

SOLLEY MATTHEW PAUL1 2A

MW BRO BRO

FL

S SLT MED

FL

6 6-3A 00005 0CCOV/ALCOHOL

___-_______

___-__-____

___ ___-____

___-__________ ___-____

___-_______352 287-4341

34217GULF DR HOLMES BEACH50000 0

DEFENDANT WAS WALKING ON GULF DR IN THE 5000 BLK CONSUMING ALCOHOL (BUDWEISER)IN A BROWN PAPER BAG. IMADE CONATCT WITH HIM AND ISSUED A COV CITATION FOR ALCOHOL.

BORESSGT.COPEMAN 307

326

1

EVEN

TD

ATA

NA

RR

ATI

VESU

SPEC

T

00. N/A01. Gunshot02. Stabbed

CO

DES

AD

M

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 2

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims00. N/A01. Handgun

05. Knife/Cutting Instrument06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - OtherRace

N - N/AM - MaleF - FemaleU - Unknown

Residence Type 0. N/A1. City2. County

Extent of Injury Residence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender 07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

Residence Phone

Business Phone

Juvenile

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

30. Other Mobile99. Other

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

0. N/A1. Occupied

E-EscapeeZ-Other

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

13. Drugs88. Unknown99. Other

Grid

Victim Type 0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

Susp. #

VIC

TIM

/WIT

NES

SVI

CTI

M/W

ITN

ESS

# Prem. Ent.

S-SuspectA-Arrestee

Dom. Violence

Dom. Violence

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

Age

Date of Birth Age

Date of Birth Age

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

V. TypeOFF/INC Indicator

If V/W Code is V, W or CFill in this Line

1.#12.#2

3.Both

OFF/INC Indicator

If V/W Code is V, W or CFill in this Line

1.#12.#2

3.Both

Person/Unit Notified

Case Status

Time

Routed To Referred

Related Report Number(s)

Unit

ofPage

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary Offense Secondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

ISTR

ATI

VE

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

1. Original2. Supplement

Juvenilein Report

JuvenileWarn/Dismiss

1

__/__/____04/19/2017

04/19/2017 04/19/2017

__/__/____

04/20/2017__/__/____

09/21/1975

Signature of Officer Reporting

Signature of Officer Reviewing

Yes No

YYeess NNoo

12 NOFFENSE-INCIDENT REPORTGangRelated

C O P

Y