# Zenith City Police - 911

# Incident Report Form / Call Log Form

<table>
<colgroup>
<col style="width: 13%" />
<col style="width: 1%" />
<col style="width: 0%" />
<col style="width: 9%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 4%" />
<col style="width: 1%" />
<col style="width: 5%" />
<col style="width: 3%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 1%" />
<col style="width: 5%" />
<col style="width: 1%" />
<col style="width: 0%" />
<col style="width: 16%" />
<col style="width: 5%" />
<col style="width: 11%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="21"><h1 id="incident-datetime">INCIDENT DATE/TIME</h1></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2">Date Printed:</td>
<td colspan="2" rowspan="2"><em>10-30</em></td>
<td colspan="3" rowspan="2">Time Printed:</td>
<td colspan="3"><em>1:07</em></td>
<td colspan="3" rowspan="2">M.R.S. Number:</td>
<td colspan="2" rowspan="2"><em>1101</em></td>
<td colspan="4" rowspan="2">Record Number:</td>
<td rowspan="2"><em>1</em></td>
</tr>
<tr class="odd">
<td colspan="2">AM</td>
<td><h3 id="pm">PM</h3></td>
</tr>
<tr class="even">
<td colspan="21"><strong>INCIDENT DATA</strong></td>
</tr>
<tr class="odd">
<td colspan="3">Incident Type:</td>
<td colspan="18"><h4 id="theft-assault-911-call">Theft, assault – 911
Call</h4></td>
</tr>
<tr class="even">
<td colspan="3">Address of Occurrence:</td>
<td colspan="18"><em>496 Industrial Park Drive</em></td>
</tr>
<tr class="odd">
<td colspan="2">Originally Received As:</td>
<td colspan="5"><h4 id="phone-in">Phone in</h4></td>
<td colspan="5">Weapon or Objects Used:</td>
<td colspan="6"></td>
<td></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">How Received:</td>
<td colspan="5"></td>
<td colspan="5">Reporting Officer:</td>
<td colspan="6"><em>Off. Brown, Charles</em></td>
<td>Domestic:</td>
<td colspan="2"><h4 id="no">No</h4></td>
</tr>
<tr class="odd">
<td colspan="2">Type of Premises</td>
<td colspan="5"><em>Retail store</em></td>
<td colspan="5">Other Offices Notified:</td>
<td colspan="6"></td>
<td>Complaint Status:</td>
<td colspan="2"><em>Cleared by arrest</em></td>
</tr>
<tr class="even">
<td colspan="2">Copies To:</td>
<td colspan="5"></td>
<td colspan="5"></td>
<td colspan="6"></td>
<td>Arson Related:</td>
<td colspan="2"><em>No</em></td>
</tr>
<tr class="odd">
<td colspan="2" rowspan="2">Occurred From:</td>
<td colspan="2">Date</td>
<td colspan="3">Time</td>
<td colspan="5" rowspan="2">To:</td>
<td colspan="3">Date</td>
<td colspan="3">Time</td>
<td rowspan="2">Officer Injured:</td>
<td colspan="2" rowspan="2"><em>No</em></td>
</tr>
<tr class="even">
<td colspan="2"><em>10-30</em></td>
<td colspan="3"><em>12:04 PM</em></td>
<td colspan="3"></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="2">Date Reported</td>
<td colspan="5"><em>10-30</em></td>
<td colspan="5">Call Received:</td>
<td colspan="6"><em>12:06 PM</em></td>
<td>Car Number:</td>
<td colspan="2"><em>2</em></td>
</tr>
<tr class="even">
<td colspan="2">Time Reported:</td>
<td colspan="5"><em>12:07 PM</em></td>
<td colspan="5">Time of Arrival:</td>
<td colspan="6"><em>12:15 PM</em></td>
<td>District:</td>
<td colspan="2"><em>South Zenith</em></td>
</tr>
<tr class="odd">
<td colspan="2">Officer Assaulted or Killed:</td>
<td colspan="5"><em>No</em></td>
<td colspan="5">GEO Code:</td>
<td colspan="6"><em>55</em></td>
<td>Processed By:</td>
<td colspan="2"><em>Thompson, Stanford</em></td>
</tr>
<tr class="even">
<td colspan="21"><strong>BURGLARY DATA</strong></td>
</tr>
<tr class="odd">
<td colspan="2">Method of Entry:</td>
<td colspan="5"><h4 id="na">N/A</h4></td>
<td colspan="5">Burglary Type:</td>
<td colspan="6"><h4 id="na-1">N/A</h4></td>
<td>Point of Entry Visible to Patrol:</td>
<td colspan="2"><h4 id="na-2">N/A</h4></td>
</tr>
<tr class="even">
<td colspan="21"><strong>REPORTING PARTY</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="20"><h4 id="burger-frank">Burger, Frank</h4></td>
</tr>
<tr class="even">
<td>Home Address:</td>
<td colspan="20"><em>14 Bobs Lane</em></td>
</tr>
<tr class="odd">
<td>Occupation:</td>
<td colspan="20"><em>Store Owner</em></td>
</tr>
<tr class="even">
<td>Relation:</td>
<td colspan="20"><em>Owner</em></td>
</tr>
<tr class="odd">
<td>SSN:</td>
<td colspan="20"><em>526-95-7853</em></td>
</tr>
<tr class="even">
<td>Date of Birth:</td>
<td colspan="5"><em>05-23</em></td>
<td colspan="3">Sex:</td>
<td colspan="2"><h3 id="m">M </h3></td>
<td colspan="2">F</td>
<td colspan="4">Place of Birth:</td>
<td colspan="4"><em>CO</em></td>
</tr>
<tr class="odd">
<td>Age:</td>
<td colspan="5"><em>41</em></td>
<td colspan="3">Race:</td>
<td colspan="4"><h4 id="caucasian">Caucasian</h4></td>
<td colspan="4">Marital Status:</td>
<td colspan="4"><em>Married</em></td>
</tr>
</tbody>
</table>

+--------+--------+--------+---+---+--------+-----------------------+
| **VI   |        |        |   |   |        |                       |
| CTIM** |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Name:  | #### S |        |   |   |        |                       |
|        | ame as |        |   |   |        |                       |
|        |  Above |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Home   |        |        |   |   |        |                       |
| Ad     |        |        |   |   |        |                       |
| dress: |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Occup  |        |        |   |   |        |                       |
| ation: |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Rel    |        |        |   |   |        |                       |
| ation: |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| SSN:   |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Date   |        | Sex:   | M | F | Place  |                       |
| of     |        |        |   |   | of     |                       |
| Birth: |        |        |   |   | Birth: |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Age:   |        | Race:  |   |   | M      |                       |
|        |        |        |   |   | arital |                       |
|        |        |        |   |   | S      |                       |
|        |        |        |   |   | tatus: |                       |
+--------+--------+--------+---+---+--------+-----------------------+

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 0%" />
<col style="width: 10%" />
<col style="width: 8%" />
<col style="width: 12%" />
<col style="width: 18%" />
<col style="width: 2%" />
<col style="width: 4%" />
<col style="width: 6%" />
<col style="width: 10%" />
<col style="width: 10%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="11"><strong>KNOWN SUSPECT #1</strong></td>
</tr>
<tr class="even">
<td>Name:</td>
<td colspan="10"><h4 id="troy-dimetrius">Troy, Dimetrius</h4></td>
</tr>
<tr class="odd">
<td colspan="2">Date of Birth:</td>
<td><em>02-21</em></td>
<td colspan="2">Sex: <em>M</em></td>
<td>SS#:<em>654-54-6543</em></td>
<td colspan="2">Age:</td>
<td><em>21</em></td>
<td>Race:</td>
<td><h4 id="black">Black</h4></td>
</tr>
<tr class="even">
<td colspan="2">Height:</td>
<td><em>6’3”</em></td>
<td colspan="2">Hair Color:</td>
<td><h4 id="black-1">Black</h4></td>
<td colspan="3">Injured:</td>
<td colspan="2"><em>No</em></td>
</tr>
<tr class="odd">
<td colspan="2">Weight:</td>
<td><em>210</em></td>
<td colspan="2">Hair Length:</td>
<td><em>Short</em></td>
<td colspan="3">Hospital:</td>
<td colspan="2"><em>no</em></td>
</tr>
<tr class="even">
<td colspan="2">Build:</td>
<td><em>Heavy</em></td>
<td colspan="2">Hair Style:</td>
<td><em>Crew</em></td>
<td colspan="3">Hospital Disposition:</td>
<td colspan="2"><em>N/A</em></td>
</tr>
<tr class="odd">
<td colspan="2">Complexion:</td>
<td><em>Dark</em></td>
<td colspan="2">Facial Hair:</td>
<td><em>no</em></td>
<td colspan="3">Conveyed By:</td>
<td colspan="2"><em>Police cruiser</em></td>
</tr>
<tr class="even">
<td colspan="2">Eye Color:</td>
<td><em>Brown</em></td>
<td colspan="2">AR#:</td>
<td><em>21</em></td>
<td colspan="3">Injury Type:</td>
<td colspan="2"><em>N/A</em></td>
</tr>
<tr class="odd">
<td colspan="11">CHARGES</td>
</tr>
<tr class="even">
<td colspan="11"><h5 id="theft-assault">THEFT, ASSAULT</h5></td>
</tr>
<tr class="odd">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</td>
</tr>
<tr class="even">
<td colspan="4"><em>484, 38</em></td>
<td colspan="3"><em>3512</em></td>
<td colspan="4"><h5 id="m-1">M</h5></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="11"><strong>KNOWN SUSPECT #2</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="10"><h4 id="johnson-jordan">Johnson, Jordan</h4></td>
</tr>
<tr class="even">
<td colspan="2">Date of Birth:</td>
<td><em>02-12</em></td>
<td colspan="2">Sex: M</td>
<td>SS#: <em>789-78-7894</em></td>
<td colspan="2">Age:</td>
<td><em>22</em></td>
<td>Race:</td>
<td><h4 id="caucasian-1">Caucasian</h4></td>
</tr>
<tr class="odd">
<td colspan="2">Height:</td>
<td><em>6’5”</em></td>
<td colspan="2">Hair Color:</td>
<td><h4 id="brown">Brown</h4></td>
<td colspan="3">Injured:</td>
<td colspan="2"><h4 id="no-1">No</h4></td>
</tr>
<tr class="even">
<td colspan="2">Weight:</td>
<td><em>185</em></td>
<td colspan="2">Hair Length:</td>
<td><em>Short</em></td>
<td colspan="3">Hospital:</td>
<td colspan="2"><em>No</em></td>
</tr>
<tr class="odd">
<td colspan="2">Build:</td>
<td><em>Medium</em></td>
<td colspan="2">Hair Style:</td>
<td><em>Crew</em></td>
<td colspan="3">Hospital Disposition:</td>
<td colspan="2"><em>N/A</em></td>
</tr>
<tr class="even">
<td colspan="2">Complexion:</td>
<td><em>Light</em></td>
<td colspan="2">Facial Hair:</td>
<td><em>Mustache</em></td>
<td colspan="3">Conveyed By:</td>
<td colspan="2"><em>Police cruiser</em></td>
</tr>
<tr class="odd">
<td colspan="2">Eye Color:</td>
<td><em>Brown</em></td>
<td colspan="2">AR#:</td>
<td><em>25</em></td>
<td colspan="3">Injury Type:</td>
<td colspan="2"><em>N/A</em></td>
</tr>
<tr class="even">
<td colspan="11"><p>CHARGES</p>
<h5 id="theft">THEFT</h5></td>
</tr>
<tr class="odd">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</td>
</tr>
<tr class="even">
<td colspan="4"><em>484</em></td>
<td colspan="3"><em>3512</em></td>
<td colspan="4"><em>M</em></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="11"><strong>KNOWN SUSPECT #3</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="10"></td>
</tr>
<tr class="even">
<td colspan="2">Date of Birth:</td>
<td></td>
<td colspan="2">Sex:</td>
<td>SS#:</td>
<td colspan="2">Age:</td>
<td></td>
<td>Race:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Height:</td>
<td></td>
<td colspan="2">Hair Color:</td>
<td></td>
<td colspan="3">Injured:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Weight:</td>
<td></td>
<td colspan="2">Hair Length:</td>
<td></td>
<td colspan="3">Hospital:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Build:</td>
<td></td>
<td colspan="2">Hair Style:</td>
<td></td>
<td colspan="3">Hospital Disposition:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Complexion:</td>
<td></td>
<td colspan="2">Facial Hair:</td>
<td></td>
<td colspan="3">Conveyed By:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Eye Color:</td>
<td></td>
<td colspan="2">AR#:</td>
<td></td>
<td colspan="3">Injury Type:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="11">CHARGES</td>
</tr>
<tr class="odd">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
</tbody>
</table>

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 12%" />
<col style="width: 3%" />
<col style="width: 14%" />
<col style="width: 2%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 5%" />
<col style="width: 11%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="13"><h1 id="property">PROPERTY</h1></td>
</tr>
<tr class="even">
<td>Owner’s Name:</td>
<td colspan="12">Burger, Frank</td>
</tr>
<tr class="odd">
<td colspan="13">Item Number: 1</td>
</tr>
<tr class="even">
<td colspan="2">Property Code:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td colspan="2">$654</td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Quantity:</td>
<td colspan="2">1</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td colspan="2">returned</td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Property Description:</td>
<td colspan="2">Gold bracelet</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td colspan="2">Burger, Frank</td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="13"><h1 id="vehicle">VEHICLE</h1></td>
</tr>
<tr class="even">
<td colspan="3">Owner’s Name:</td>
<td colspan="10"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="2"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Make:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Style:</td>
<td colspan="2"></td>
<td colspan="2">Year:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="2"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Doors Locked:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Value:</td>
<td colspan="2"></td>
<td colspan="2">Other:</td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| # NARRATIVE                                                           |
+-----------------------------------------------------------------------+
| *Both suspects apprehended approximately 100 feet from store. Stolen  |
| jewelry retained as evidence.*                                        |
+-----------------------------------------------------------------------+

Reporting Officer: [*Off. Brown, Charles*]{.underline}

Supervising Officer: [*Det. Connelly, Daniel*]{.underline}

Reviewing Officer: [*Det. McCarthy, Pamela*]{.underline}

# Zenith City Police - 911

# Incident Report Form / Call Log Form

<table>
<colgroup>
<col style="width: 13%" />
<col style="width: 1%" />
<col style="width: 0%" />
<col style="width: 9%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 4%" />
<col style="width: 1%" />
<col style="width: 5%" />
<col style="width: 3%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 1%" />
<col style="width: 5%" />
<col style="width: 1%" />
<col style="width: 0%" />
<col style="width: 16%" />
<col style="width: 5%" />
<col style="width: 11%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="21"><h1 id="incident-datetime-1">INCIDENT
DATE/TIME</h1></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2">Date Printed:</td>
<td colspan="2" rowspan="2"><em>10-31</em></td>
<td colspan="3" rowspan="2">Time Printed:</td>
<td colspan="3"><em>3:12</em></td>
<td colspan="3" rowspan="2">M.R.S. Number:</td>
<td colspan="2" rowspan="2"><em>1111</em></td>
<td colspan="4" rowspan="2">Record Number:</td>
<td rowspan="2"><em>1</em></td>
</tr>
<tr class="odd">
<td colspan="2"><h3 id="am">AM</h3></td>
<td>PM</td>
</tr>
<tr class="even">
<td colspan="21"><strong>INCIDENT DATA</strong></td>
</tr>
<tr class="odd">
<td colspan="3">Incident Type:</td>
<td colspan="18"><h4
id="trespassing-unlawful-entry-911-call">Trespassing, Unlawful Entry –
911 call</h4></td>
</tr>
<tr class="even">
<td colspan="3">Address of Occurrence:</td>
<td colspan="18"><em>Forest Hills Country Club, 12 Queens
Circle</em></td>
</tr>
<tr class="odd">
<td colspan="2">Originally Received As:</td>
<td colspan="5"><h4 id="phone-in-1">Phone in</h4></td>
<td colspan="5">Weapon or Objects Used:</td>
<td colspan="6"><h4 id="na-3">N/A</h4></td>
<td></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">How Received:</td>
<td colspan="5"></td>
<td colspan="5">Reporting Officer:</td>
<td colspan="6"><em>Off. Brown, Charles</em></td>
<td>Domestic:</td>
<td colspan="2"><h4 id="no-2">No</h4></td>
</tr>
<tr class="odd">
<td colspan="2">Type of Premises</td>
<td colspan="5"></td>
<td colspan="5">Other Offices Notified:</td>
<td colspan="6"></td>
<td>Complaint Status:</td>
<td colspan="2"><em>Cleared with Arrest</em></td>
</tr>
<tr class="even">
<td colspan="2">Copies To:</td>
<td colspan="5"></td>
<td colspan="5"></td>
<td colspan="6"></td>
<td>Arson Related:</td>
<td colspan="2"><em>No</em></td>
</tr>
<tr class="odd">
<td colspan="2" rowspan="2">Occurred From:</td>
<td colspan="2">Date</td>
<td colspan="3">Time</td>
<td colspan="5" rowspan="2">To:</td>
<td colspan="3">Date</td>
<td colspan="3">Time</td>
<td rowspan="2">Officer Injured:</td>
<td colspan="2" rowspan="2"></td>
</tr>
<tr class="even">
<td colspan="2"><em>10-31</em></td>
<td colspan="3"><em>2:10 AM</em></td>
<td colspan="3"></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="2">Date Reported</td>
<td colspan="5"><em>10-31</em></td>
<td colspan="5">Call Received:</td>
<td colspan="6"><em>2:11 AM</em></td>
<td>Car Number:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Time Reported:</td>
<td colspan="5"><em>2:12 AM</em></td>
<td colspan="5">Time of Arrival:</td>
<td colspan="6"><em>2:20 AM</em></td>
<td>District:</td>
<td colspan="2"><em>Forest Hills</em></td>
</tr>
<tr class="odd">
<td colspan="2">Officer Assaulted or Killed:</td>
<td colspan="5"><em>No</em></td>
<td colspan="5">GEO Code:</td>
<td colspan="6"><em>44</em></td>
<td>Processed By:</td>
<td colspan="2"><em>Thompson, Stanford</em></td>
</tr>
<tr class="even">
<td colspan="21"><strong>BURGLARY DATA</strong></td>
</tr>
<tr class="odd">
<td colspan="2">Method of Entry:</td>
<td colspan="5"><h4 id="unlawful-entry">Unlawful Entry</h4></td>
<td colspan="5">Burglary Type:</td>
<td colspan="6"><em>Night (6 PM – 6 AM)</em></td>
<td>Point of Entry Visible to Patrol:</td>
<td colspan="2"><em>Yes, Bottom Left Rear Window</em></td>
</tr>
<tr class="even">
<td colspan="21"><strong>REPORTING PARTY</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="20"><h4 id="summers-stephen">Summers, Stephen</h4></td>
</tr>
<tr class="even">
<td>Home Address:</td>
<td colspan="20"><em>23 Kennedy Road</em></td>
</tr>
<tr class="odd">
<td>Occupation:</td>
<td colspan="20"><em>Janitor</em></td>
</tr>
<tr class="even">
<td>Relation:</td>
<td colspan="20"><em>Employee</em></td>
</tr>
<tr class="odd">
<td>SSN:</td>
<td colspan="20"><em>987-87-6543</em></td>
</tr>
<tr class="even">
<td>Date of Birth:</td>
<td colspan="5"><em>03-05</em></td>
<td colspan="3">Sex:</td>
<td colspan="2"><h3 id="m-2">M </h3></td>
<td colspan="2">F</td>
<td colspan="4">Place of Birth:</td>
<td colspan="4"><em>MI</em></td>
</tr>
<tr class="odd">
<td>Age:</td>
<td colspan="5"><em>59</em></td>
<td colspan="3">Race:</td>
<td colspan="4"><h4 id="caucasian-2">Caucasian</h4></td>
<td colspan="4">Marital Status:</td>
<td colspan="4"><em>Divorced</em></td>
</tr>
</tbody>
</table>

+--------+--------+--------+---+---+--------+-----------------------+
| **VI   |        |        |   |   |        |                       |
| CTIM** |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Name:  | ####   |        |   |   |        |                       |
|        |  N/A { |        |   |   |        |                       |
|        | #na-4} |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Home   |        |        |   |   |        |                       |
| Ad     |        |        |   |   |        |                       |
| dress: |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Occup  |        |        |   |   |        |                       |
| ation: |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Rel    |        |        |   |   |        |                       |
| ation: |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| SSN:   |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Date   |        | Sex:   | M | F | Place  |                       |
| of     |        |        |   |   | of     |                       |
| Birth: |        |        |   |   | Birth: |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Age:   |        | Race:  |   |   | M      |                       |
|        |        |        |   |   | arital |                       |
|        |        |        |   |   | S      |                       |
|        |        |        |   |   | tatus: |                       |
+--------+--------+--------+---+---+--------+-----------------------+

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 0%" />
<col style="width: 10%" />
<col style="width: 8%" />
<col style="width: 12%" />
<col style="width: 18%" />
<col style="width: 2%" />
<col style="width: 4%" />
<col style="width: 6%" />
<col style="width: 10%" />
<col style="width: 10%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="11"><strong>KNOWN SUSPECT #1</strong></td>
</tr>
<tr class="even">
<td>Name:</td>
<td colspan="10"><h4 id="roberts-brian">Roberts, Brian</h4></td>
</tr>
<tr class="odd">
<td colspan="2">Date of Birth:</td>
<td><em>08-15</em></td>
<td colspan="2">Sex: <em>M</em></td>
<td>SS#: <em>523-85-4126</em></td>
<td colspan="2">Age:</td>
<td><em>17</em></td>
<td>Race:</td>
<td><h4 id="caucasian-3">Caucasian</h4></td>
</tr>
<tr class="even">
<td colspan="2">Height:</td>
<td><em>5’8”</em></td>
<td colspan="2">Hair Color:</td>
<td><h4 id="brown-1">Brown</h4></td>
<td colspan="3">Injured:</td>
<td colspan="2"><h4 id="no-3">No</h4></td>
</tr>
<tr class="odd">
<td colspan="2">Weight:</td>
<td><em>145</em></td>
<td colspan="2">Hair Length:</td>
<td><h4 id="short">Short</h4></td>
<td colspan="3">Hospital:</td>
<td colspan="2"><em>No</em></td>
</tr>
<tr class="even">
<td colspan="2">Build:</td>
<td><h4 id="medium">Medium</h4></td>
<td colspan="2">Hair Style:</td>
<td><em>Crew</em></td>
<td colspan="3">Hospital Disposition:</td>
<td colspan="2"><em>N/A</em></td>
</tr>
<tr class="odd">
<td colspan="2">Complexion:</td>
<td><h4 id="fair">Fair</h4></td>
<td colspan="2">Facial Hair:</td>
<td><em>No</em></td>
<td colspan="3">Conveyed By:</td>
<td colspan="2"><em>Police cruiser</em></td>
</tr>
<tr class="even">
<td colspan="2">Eye Color:</td>
<td><h4 id="brown-2">Brown</h4></td>
<td colspan="2">AR#:</td>
<td><em>42</em></td>
<td colspan="3">Injury Type:</td>
<td colspan="2"><em>N/A</em></td>
</tr>
<tr class="odd">
<td colspan="11">CHARGES</td>
</tr>
<tr class="even">
<td colspan="11"><h5 id="unlawful-entry-trespassing">UNLAWFUL ENTRY,
TRESPASSING</h5></td>
</tr>
<tr class="odd">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</td>
</tr>
<tr class="even">
<td colspan="4"><em>603, 602</em></td>
<td colspan="3"><em>1234</em></td>
<td colspan="4"><em>M</em></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="11"><strong>KNOWN SUSPECT #2</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="10"></td>
</tr>
<tr class="even">
<td colspan="2">Date of Birth:</td>
<td></td>
<td colspan="2">Sex:</td>
<td>SS#:</td>
<td colspan="2">Age:</td>
<td></td>
<td>Race:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Height:</td>
<td></td>
<td colspan="2">Hair Color:</td>
<td></td>
<td colspan="3">Injured:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Weight:</td>
<td></td>
<td colspan="2">Hair Length:</td>
<td></td>
<td colspan="3">Hospital:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Build:</td>
<td></td>
<td colspan="2">Hair Style:</td>
<td></td>
<td colspan="3">Hospital Disposition:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Complexion:</td>
<td></td>
<td colspan="2">Facial Hair:</td>
<td></td>
<td colspan="3">Conveyed By:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Eye Color:</td>
<td></td>
<td colspan="2">AR#:</td>
<td></td>
<td colspan="3">Injury Type:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="11">CHARGES</td>
</tr>
<tr class="odd">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="11"><strong>KNOWN SUSPECT #3</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="10"></td>
</tr>
<tr class="even">
<td colspan="2">Date of Birth:</td>
<td></td>
<td colspan="2">Sex:</td>
<td>SS#:</td>
<td colspan="2">Age:</td>
<td></td>
<td>Race:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Height:</td>
<td></td>
<td colspan="2">Hair Color:</td>
<td></td>
<td colspan="3">Injured:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Weight:</td>
<td></td>
<td colspan="2">Hair Length:</td>
<td></td>
<td colspan="3">Hospital:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Build:</td>
<td></td>
<td colspan="2">Hair Style:</td>
<td></td>
<td colspan="3">Hospital Disposition:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Complexion:</td>
<td></td>
<td colspan="2">Facial Hair:</td>
<td></td>
<td colspan="3">Conveyed By:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Eye Color:</td>
<td></td>
<td colspan="2">AR#:</td>
<td></td>
<td colspan="3">Injury Type:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="11">CHARGES</td>
</tr>
<tr class="odd">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
</tbody>
</table>

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 12%" />
<col style="width: 3%" />
<col style="width: 14%" />
<col style="width: 2%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 5%" />
<col style="width: 11%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="13"><h1 id="property-1">PROPERTY</h1></td>
</tr>
<tr class="even">
<td>Owner’s Name:</td>
<td colspan="12"></td>
</tr>
<tr class="odd">
<td colspan="13">Item Number:</td>
</tr>
<tr class="even">
<td colspan="2">Property Code:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Quantity:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Property Description:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="13"><h1 id="vehicle-1">VEHICLE</h1></td>
</tr>
<tr class="even">
<td colspan="3">Owner’s Name:</td>
<td colspan="10"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="2"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Make:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Style:</td>
<td colspan="2"></td>
<td colspan="2">Year:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="2"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Doors Locked:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Value:</td>
<td colspan="2"></td>
<td colspan="2">Other:</td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| # NARRATIVE                                                           |
+-----------------------------------------------------------------------+
| Mr. Summers reported several youths on Country Club property, dressed |
| in costume, and apparently intoxicated. One youth, dressed as a       |
| vampire, reportedly broke in through the rear window. Upon arrival,   |
| officer arrested the youth, and called the parents of the remaining   |
| youths.                                                               |
+-----------------------------------------------------------------------+

Reporting Officer: [*Off. Brown,Charles*]{.underline}

Supervising Officer: [*Det. Connelly, Daniel*]{.underline}

Reviewing Officer: [*Det. McCarthy, Pamela*]{.underline}

# Zenith City Police - 911

# Incident Report Form / Call Log Form

<table>
<colgroup>
<col style="width: 13%" />
<col style="width: 1%" />
<col style="width: 0%" />
<col style="width: 9%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 4%" />
<col style="width: 1%" />
<col style="width: 5%" />
<col style="width: 3%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 1%" />
<col style="width: 5%" />
<col style="width: 1%" />
<col style="width: 0%" />
<col style="width: 16%" />
<col style="width: 5%" />
<col style="width: 11%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="21"><h1 id="incident-datetime-2">INCIDENT
DATE/TIME</h1></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2">Date Printed:</td>
<td colspan="2" rowspan="2"><em>10-31</em></td>
<td colspan="3" rowspan="2">Time Printed:</td>
<td colspan="3"><em>1:12</em></td>
<td colspan="3" rowspan="2">M.R.S. Number:</td>
<td colspan="2" rowspan="2"><em>1112</em></td>
<td colspan="4" rowspan="2">Record Number:</td>
<td rowspan="2"><em>2</em></td>
</tr>
<tr class="odd">
<td colspan="2">AM</td>
<td><h3 id="pm-1">PM</h3></td>
</tr>
<tr class="even">
<td colspan="21"><strong>INCIDENT DATA</strong></td>
</tr>
<tr class="odd">
<td colspan="3">Incident Type:</td>
<td colspan="18"><h4 id="accident-911-call">Accident – 911
call</h4></td>
</tr>
<tr class="even">
<td colspan="3">Address of Occurrence:</td>
<td colspan="18"><em>46 Trout Brook Road</em></td>
</tr>
<tr class="odd">
<td colspan="2">Originally Received As:</td>
<td colspan="5"><h4 id="phone-in-2">Phone in </h4></td>
<td colspan="5">Weapon or Objects Used:</td>
<td colspan="6"><h4 id="na-5">N/A</h4></td>
<td></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">How Received:</td>
<td colspan="5"></td>
<td colspan="5">Reporting Officer:</td>
<td colspan="6"><em>Off. Avery, Mark</em></td>
<td>Domestic:</td>
<td colspan="2"><h4 id="no-4">No</h4></td>
</tr>
<tr class="odd">
<td colspan="2">Type of Premises</td>
<td colspan="5"></td>
<td colspan="5">Other Offices Notified:</td>
<td colspan="6"></td>
<td>Complaint Status:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Copies To:</td>
<td colspan="5"></td>
<td colspan="5"></td>
<td colspan="6"></td>
<td>Arson Related:</td>
<td colspan="2"><em>No</em></td>
</tr>
<tr class="odd">
<td colspan="2" rowspan="2">Occurred From:</td>
<td colspan="2">Date</td>
<td colspan="3">Time</td>
<td colspan="5" rowspan="2">To:</td>
<td colspan="3">Date</td>
<td colspan="3">Time</td>
<td rowspan="2">Officer Injured:</td>
<td colspan="2" rowspan="2"><em>No</em></td>
</tr>
<tr class="even">
<td colspan="2"><em>10-31</em></td>
<td colspan="3"><em>12:11 P</em></td>
<td colspan="3"></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="2">Date Reported</td>
<td colspan="5"></td>
<td colspan="5">Call Received:</td>
<td colspan="6"><em>12:12 PM</em></td>
<td>Car Number:</td>
<td colspan="2"><em>3</em></td>
</tr>
<tr class="even">
<td colspan="2">Time Reported:</td>
<td colspan="5"><em>12:12 PM</em></td>
<td colspan="5">Time of Arrival:</td>
<td colspan="6"><em>12:17 PM</em></td>
<td>District:</td>
<td colspan="2"><em>South Zenith</em></td>
</tr>
<tr class="odd">
<td colspan="2">Officer Assaulted or Killed:</td>
<td colspan="5"><em>No</em></td>
<td colspan="5">GEO Code:</td>
<td colspan="6"><em>33</em></td>
<td>Processed By:</td>
<td colspan="2"><em>Adams, Brian</em></td>
</tr>
<tr class="even">
<td colspan="21"><strong>BURGLARY DATA</strong></td>
</tr>
<tr class="odd">
<td colspan="2">Method of Entry:</td>
<td colspan="5"><h4 id="na-6">N/A</h4></td>
<td colspan="5">Burglary Type:</td>
<td colspan="6"><h4 id="na-7">N/A</h4></td>
<td>Point of Entry Visible to Patrol:</td>
<td colspan="2"><h4 id="na-8">N/A</h4></td>
</tr>
<tr class="even">
<td colspan="21"><strong>REPORTING PARTY</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="20"><h4 id="frye-carrie">Frye, Carrie</h4></td>
</tr>
<tr class="even">
<td>Home Address:</td>
<td colspan="20"><em>10 Bobs Lane</em></td>
</tr>
<tr class="odd">
<td>Occupation:</td>
<td colspan="20"><em>Teacher</em></td>
</tr>
<tr class="even">
<td>Relation:</td>
<td colspan="20"><em>witness</em></td>
</tr>
<tr class="odd">
<td>SSN:</td>
<td colspan="20"><em>522-10-1205</em></td>
</tr>
<tr class="even">
<td>Date of Birth:</td>
<td colspan="5"><em>09-09</em></td>
<td colspan="3">Sex:</td>
<td colspan="2">M</td>
<td colspan="2"><h3 id="f">F</h3></td>
<td colspan="4">Place of Birth:</td>
<td colspan="4"><em>ME</em></td>
</tr>
<tr class="odd">
<td>Age:</td>
<td colspan="5"><em>34</em></td>
<td colspan="3">Race:</td>
<td colspan="4"><h4 id="caucasian-4">Caucasian</h4></td>
<td colspan="4">Marital Status:</td>
<td colspan="4"><em>Single</em></td>
</tr>
</tbody>
</table>

+--------+--------+--------+---+---+--------+-----------------------+
| **VI   |        |        |   |   |        |                       |
| CTIM** |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Name:  | ###    |        |   |   |        |                       |
|        | # Quin |        |   |   |        |                       |
|        | n, Ann |        |   |   |        |                       |
|        |  Marie |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Home   | *3 Bay |        |   |   |        |                       |
| Ad     | Road*  |        |   |   |        |                       |
| dress: |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Occup  | *N/A*  |        |   |   |        |                       |
| ation: |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Rel    |        |        |   |   |        |                       |
| ation: |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| SSN:   | *      |        |   |   |        |                       |
|        | 015-12 |        |   |   |        |                       |
|        | -1235* |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Date   | *      | Sex:   | M | # | Place  | *ME*                  |
| of     | 05-06* |        |   | # | of     |                       |
| Birth: |        |        |   | # | Birth: |                       |
|        |        |        |   |   |        |                       |
|        |        |        |   | F |        |                       |
|        |        |        |   |   |        |                       |
|        |        |        |   | { |        |                       |
|        |        |        |   | # |        |                       |
|        |        |        |   | f |        |                       |
|        |        |        |   | - |        |                       |
|        |        |        |   | 1 |        |                       |
|        |        |        |   | } |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Age:   | *7*    | Race:  | # |   | M      | *N/A*                 |
|        |        |        | # |   | arital |                       |
|        |        |        | # |   | S      |                       |
|        |        |        | # |   | tatus: |                       |
|        |        |        |   |   |        |                       |
|        |        |        | C |   |        |                       |
|        |        |        | a |   |        |                       |
|        |        |        | u |   |        |                       |
|        |        |        | c |   |        |                       |
|        |        |        | a |   |        |                       |
|        |        |        | s |   |        |                       |
|        |        |        | i |   |        |                       |
|        |        |        | a |   |        |                       |
|        |        |        | n |   |        |                       |
|        |        |        |   |   |        |                       |
|        |        |        | { |   |        |                       |
|        |        |        | # |   |        |                       |
|        |        |        | c |   |        |                       |
|        |        |        | a |   |        |                       |
|        |        |        | u |   |        |                       |
|        |        |        | c |   |        |                       |
|        |        |        | a |   |        |                       |
|        |        |        | s |   |        |                       |
|        |        |        | i |   |        |                       |
|        |        |        | a |   |        |                       |
|        |        |        | n |   |        |                       |
|        |        |        | - |   |        |                       |
|        |        |        | 5 |   |        |                       |
|        |        |        | } |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 0%" />
<col style="width: 10%" />
<col style="width: 8%" />
<col style="width: 12%" />
<col style="width: 18%" />
<col style="width: 2%" />
<col style="width: 4%" />
<col style="width: 6%" />
<col style="width: 10%" />
<col style="width: 10%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="11"><strong>KNOWN SUSPECT #1</strong></td>
</tr>
<tr class="even">
<td>Name:</td>
<td colspan="10"><h4 id="unk">UNK</h4></td>
</tr>
<tr class="odd">
<td colspan="2">Date of Birth:</td>
<td></td>
<td colspan="2">Sex:</td>
<td>SS#:</td>
<td colspan="2">Age:</td>
<td></td>
<td>Race:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Height:</td>
<td></td>
<td colspan="2">Hair Color:</td>
<td></td>
<td colspan="3">Injured:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Weight:</td>
<td></td>
<td colspan="2">Hair Length:</td>
<td></td>
<td colspan="3">Hospital:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Build:</td>
<td></td>
<td colspan="2">Hair Style:</td>
<td></td>
<td colspan="3">Hospital Disposition:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Complexion:</td>
<td></td>
<td colspan="2">Facial Hair:</td>
<td></td>
<td colspan="3">Conveyed By:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Eye Color:</td>
<td></td>
<td colspan="2">AR#:</td>
<td></td>
<td colspan="3">Injury Type:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="11">CHARGES</td>
</tr>
<tr class="even">
<td colspan="11">CHARGES</td>
</tr>
<tr class="odd">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="11"><strong>KNOWN SUSPECT #2</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="10"></td>
</tr>
<tr class="even">
<td colspan="2">Date of Birth:</td>
<td></td>
<td colspan="2">Sex:</td>
<td>SS#:</td>
<td colspan="2">Age:</td>
<td></td>
<td>Race:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Height:</td>
<td></td>
<td colspan="2">Hair Color:</td>
<td></td>
<td colspan="3">Injured:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Weight:</td>
<td></td>
<td colspan="2">Hair Length:</td>
<td></td>
<td colspan="3">Hospital:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Build:</td>
<td></td>
<td colspan="2">Hair Style:</td>
<td></td>
<td colspan="3">Hospital Disposition:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Complexion:</td>
<td></td>
<td colspan="2">Facial Hair:</td>
<td></td>
<td colspan="3">Conveyed By:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Eye Color:</td>
<td></td>
<td colspan="2">AR#:</td>
<td></td>
<td colspan="3">Injury Type:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="11">CHARGES</td>
</tr>
<tr class="odd">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="11"><strong>KNOWN SUSPECT #3</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="10"></td>
</tr>
<tr class="even">
<td colspan="2">Date of Birth:</td>
<td></td>
<td colspan="2">Sex:</td>
<td>SS#:</td>
<td colspan="2">Age:</td>
<td></td>
<td>Race:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Height:</td>
<td></td>
<td colspan="2">Hair Color:</td>
<td></td>
<td colspan="3">Injured:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Weight:</td>
<td></td>
<td colspan="2">Hair Length:</td>
<td></td>
<td colspan="3">Hospital:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Build:</td>
<td></td>
<td colspan="2">Hair Style:</td>
<td></td>
<td colspan="3">Hospital Disposition:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Complexion:</td>
<td></td>
<td colspan="2">Facial Hair:</td>
<td></td>
<td colspan="3">Conveyed By:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Eye Color:</td>
<td></td>
<td colspan="2">AR#:</td>
<td></td>
<td colspan="3">Injury Type:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="11">CHARGES</td>
</tr>
<tr class="odd">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
</tbody>
</table>

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 12%" />
<col style="width: 3%" />
<col style="width: 14%" />
<col style="width: 2%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 5%" />
<col style="width: 11%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="13"><h1 id="property-2">PROPERTY</h1></td>
</tr>
<tr class="even">
<td>Owner’s Name:</td>
<td colspan="12"></td>
</tr>
<tr class="odd">
<td colspan="13">Item Number:</td>
</tr>
<tr class="even">
<td colspan="2">Property Code:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Quantity:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Property Description:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="13"><h1 id="vehicle-2">VEHICLE</h1></td>
</tr>
<tr class="even">
<td colspan="3">Owner’s Name:</td>
<td colspan="10"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="2"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Make:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Style:</td>
<td colspan="2"></td>
<td colspan="2">Year:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="2"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Doors Locked:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Value:</td>
<td colspan="2"></td>
<td colspan="2">Other:</td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| # NARRATIVE                                                           |
+-----------------------------------------------------------------------+
| *Victim was participating in Halloween Parade and apparently ran into |
| the street, where she was hit by a car. The driver sped off; no       |
| suspect description nor license number is available. Victim was       |
| airlifted to Sacred Heart Hospital.*                                  |
+-----------------------------------------------------------------------+

Reporting Officer: [*Off. Avery, Mark*]{.underline}

Supervising Officer: [*Det. Connelly, Daniel*]{.underline}

Reviewing Officer: [*Det. McCarthy, Pamela*]{.underline}

# Zenith City Police - 911

# Incident Report Form / Call Log Form

<table>
<colgroup>
<col style="width: 13%" />
<col style="width: 1%" />
<col style="width: 0%" />
<col style="width: 9%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 4%" />
<col style="width: 1%" />
<col style="width: 5%" />
<col style="width: 3%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 1%" />
<col style="width: 5%" />
<col style="width: 1%" />
<col style="width: 0%" />
<col style="width: 16%" />
<col style="width: 5%" />
<col style="width: 11%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="21"><h1 id="incident-datetime-3">INCIDENT
DATE/TIME</h1></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2">Date Printed:</td>
<td colspan="2" rowspan="2"><em>11-01</em></td>
<td colspan="3" rowspan="2">Time Printed:</td>
<td colspan="3"><em>4:52</em></td>
<td colspan="3" rowspan="2">M.R.S. Number:</td>
<td colspan="2" rowspan="2"><em>1121</em></td>
<td colspan="4" rowspan="2">Record Number:</td>
<td rowspan="2"><em>1</em></td>
</tr>
<tr class="odd">
<td colspan="2">AM</td>
<td><h3 id="pm-2">PM</h3></td>
</tr>
<tr class="even">
<td colspan="21"><strong>INCIDENT DATA</strong></td>
</tr>
<tr class="odd">
<td colspan="3">Incident Type:</td>
<td colspan="18"><h4 id="injury-911-call">Injury – 911 call</h4></td>
</tr>
<tr class="even">
<td colspan="3">Address of Occurrence:</td>
<td colspan="18"><em>106 Independence Blvd.</em></td>
</tr>
<tr class="odd">
<td colspan="2">Originally Received As:</td>
<td colspan="5"><h4 id="phone-in-3">Phone in </h4></td>
<td colspan="5">Weapon or Objects Used:</td>
<td colspan="6"><h4 id="na-9">N/A</h4></td>
<td></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">How Received:</td>
<td colspan="5"></td>
<td colspan="5">Reporting Officer:</td>
<td colspan="6"><em>Off. Avery, Mark</em></td>
<td>Domestic:</td>
<td colspan="2"><h4 id="no-5">No</h4></td>
</tr>
<tr class="odd">
<td colspan="2">Type of Premises</td>
<td colspan="5"><em>Conference Center</em></td>
<td colspan="5">Other Offices Notified:</td>
<td colspan="6"></td>
<td>Complaint Status:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Copies To:</td>
<td colspan="5"></td>
<td colspan="5"></td>
<td colspan="6"></td>
<td>Arson Related:</td>
<td colspan="2"><em>No</em></td>
</tr>
<tr class="odd">
<td colspan="2" rowspan="2">Occurred From:</td>
<td colspan="2">Date</td>
<td colspan="3">Time</td>
<td colspan="5" rowspan="2">To:</td>
<td colspan="3">Date</td>
<td colspan="3">Time</td>
<td rowspan="2">Officer Injured:</td>
<td colspan="2" rowspan="2"></td>
</tr>
<tr class="even">
<td colspan="2"><em>11-01</em></td>
<td colspan="3"><em>3:50 PM</em></td>
<td colspan="3"></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="2">Date Reported</td>
<td colspan="5"><em>11-01</em></td>
<td colspan="5">Call Received:</td>
<td colspan="6"><em>3:52 PM</em></td>
<td>Car Number:</td>
<td colspan="2"><em>3</em></td>
</tr>
<tr class="even">
<td colspan="2">Time Reported:</td>
<td colspan="5"><em>3:52 PM</em></td>
<td colspan="5">Time of Arrival:</td>
<td colspan="6"><em>3:57 PM</em></td>
<td>District:</td>
<td colspan="2"><em>Forest Hills</em></td>
</tr>
<tr class="odd">
<td colspan="2">Officer Assaulted or Killed:</td>
<td colspan="5"><em>No</em></td>
<td colspan="5">GEO Code:</td>
<td colspan="6"><em>44</em></td>
<td>Processed By:</td>
<td colspan="2"><em>Adams, Brian</em></td>
</tr>
<tr class="even">
<td colspan="21"><strong>BURGLARY DATA</strong></td>
</tr>
<tr class="odd">
<td colspan="2">Method of Entry:</td>
<td colspan="5"><h4 id="na-10">N/A</h4></td>
<td colspan="5">Burglary Type:</td>
<td colspan="6"><h4 id="na-11">N/A</h4></td>
<td>Point of Entry Visible to Patrol:</td>
<td colspan="2"><h4 id="na-12">N/A</h4></td>
</tr>
<tr class="even">
<td colspan="21"><strong>REPORTING PARTY</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="20"><h4 id="putnam-janice">Putnam, Janice</h4></td>
</tr>
<tr class="even">
<td>Home Address:</td>
<td colspan="20"><em>14 Hawk Lane</em></td>
</tr>
<tr class="odd">
<td>Occupation:</td>
<td colspan="20"><em>Secretary</em></td>
</tr>
<tr class="even">
<td>Relation:</td>
<td colspan="20"><em>Employee</em></td>
</tr>
<tr class="odd">
<td>SSN:</td>
<td colspan="20"><em>542-85-9862</em></td>
</tr>
<tr class="even">
<td>Date of Birth:</td>
<td colspan="5"><em>12-25</em></td>
<td colspan="3">Sex:</td>
<td colspan="2">M</td>
<td colspan="2"><h3 id="f-2">F</h3></td>
<td colspan="4">Place of Birth:</td>
<td colspan="4"><em>KY</em></td>
</tr>
<tr class="odd">
<td>Age:</td>
<td colspan="5"><em>52</em></td>
<td colspan="3">Race:</td>
<td colspan="4"><h4 id="caucasian-6">Caucasian</h4></td>
<td colspan="4">Marital Status:</td>
<td colspan="4"><em>Married</em></td>
</tr>
</tbody>
</table>

+--------+--------+--------+---+---+--------+-----------------------+
| **VI   |        |        |   |   |        |                       |
| CTIM** |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Name:  | #      |        |   |   |        |                       |
|        | ### By |        |   |   |        |                       |
|        | rnes,  |        |   |   |        |                       |
|        | Daniel |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Home   | *2 Bay |        |   |   |        |                       |
| Ad     | Berry  |        |   |   |        |                       |
| dress: | Drive* |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Occup  | *Town  |        |   |   |        |                       |
| ation: | Off    |        |   |   |        |                       |
|        | icial* |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Rel    | *Sp    |        |   |   |        |                       |
| ation: | eaker* |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| SSN:   | *      |        |   |   |        |                       |
|        | 451-56 |        |   |   |        |                       |
|        | -7865* |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Date   | *      | Sex:   | # | F | Place  | #### IL               |
| of     | 11-30* |        | # |   | of     |                       |
| Birth: |        |        | # |   | Birth: |                       |
|        |        |        |   |   |        |                       |
|        |        |        | M |   |        |                       |
|        |        |        |   |   |        |                       |
|        |        |        |   |   |        |                       |
|        |        |        | { |   |        |                       |
|        |        |        | # |   |        |                       |
|        |        |        | m |   |        |                       |
|        |        |        | - |   |        |                       |
|        |        |        | 3 |   |        |                       |
|        |        |        | } |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Age:   | *56*   | Race:  | # |   | M      | *Married*             |
|        |        |        | # |   | arital |                       |
|        |        |        | # |   | S      |                       |
|        |        |        | # |   | tatus: |                       |
|        |        |        |   |   |        |                       |
|        |        |        | C |   |        |                       |
|        |        |        | a |   |        |                       |
|        |        |        | u |   |        |                       |
|        |        |        | c |   |        |                       |
|        |        |        | a |   |        |                       |
|        |        |        | s |   |        |                       |
|        |        |        | i |   |        |                       |
|        |        |        | a |   |        |                       |
|        |        |        | n |   |        |                       |
|        |        |        |   |   |        |                       |
|        |        |        | { |   |        |                       |
|        |        |        | # |   |        |                       |
|        |        |        | c |   |        |                       |
|        |        |        | a |   |        |                       |
|        |        |        | u |   |        |                       |
|        |        |        | c |   |        |                       |
|        |        |        | a |   |        |                       |
|        |        |        | s |   |        |                       |
|        |        |        | i |   |        |                       |
|        |        |        | a |   |        |                       |
|        |        |        | n |   |        |                       |
|        |        |        | - |   |        |                       |
|        |        |        | 7 |   |        |                       |
|        |        |        | } |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+

  ------------- -- ------- --------- --------- ------------ -------------- ------- ---- ------- -------
  **KNOWN                                                                                       
  SUSPECT #1**                                                                                  

  Name:                                                                                         

  Date of                  Sex:                SS#:         Age:                        Race:   
  Birth:                                                                                        

  Height:                  Hair                             Injured:                            
                           Color:                                                               

  Weight:                  Hair                             Hospital:                           
                           Length:                                                              

  Build:                   Hair                             Hospital                            
                           Style:                           Disposition:                        

  Complexion:              Facial                           Conveyed By:                        
                           Hair:                                                                

  Eye Color:               AR#:                             Injury Type:                        

  CHARGES                                                                                       

  CHARGES                                                                                       

  RSMO USC                           MO Code                               F/M/C                

                                                                                                

                                                                                                

  **KNOWN                                                                                       
  SUSPECT #2**                                                                                  

  Name:                                                                                         

  Date of                  Sex:                SS#:         Age:                        Race:   
  Birth:                                                                                        

  Height:                  Hair                             Injured:                            
                           Color:                                                               

  Weight:                  Hair                             Hospital:                           
                           Length:                                                              

  Build:                   Hair                             Hospital                            
                           Style:                           Disposition:                        

  Complexion:              Facial                           Conveyed By:                        
                           Hair:                                                                

  Eye Color:               AR#:                             Injury Type:                        

  CHARGES                                                                                       

  RSMO USC                           MO Code                               F/M/C                

                                                                                                

                                                                                                

  **KNOWN                                                                                       
  SUSPECT #3**                                                                                  

  Name:                                                                                         

  Date of                  Sex:                SS#:         Age:                        Race:   
  Birth:                                                                                        

  Height:                  Hair                             Injured:                            
                           Color:                                                               

  Weight:                  Hair                             Hospital:                           
                           Length:                                                              

  Build:                   Hair                             Hospital                            
                           Style:                           Disposition:                        

  Complexion:              Facial                           Conveyed By:                        
                           Hair:                                                                

  Eye Color:               AR#:                             Injury Type:                        

  CHARGES                                                                                       

  RSMO USC                           MO Code                               F/M/C                

                                                                                                

                                                                                                
  ------------- -- ------- --------- --------- ------------ -------------- ------- ---- ------- -------

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 12%" />
<col style="width: 3%" />
<col style="width: 14%" />
<col style="width: 2%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 5%" />
<col style="width: 11%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="13"><h1 id="property-3">PROPERTY</h1></td>
</tr>
<tr class="even">
<td>Owner’s Name:</td>
<td colspan="12"></td>
</tr>
<tr class="odd">
<td colspan="13">Item Number:</td>
</tr>
<tr class="even">
<td colspan="2">Property Code:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Quantity:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Property Description:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="13"><h1 id="vehicle-3">VEHICLE</h1></td>
</tr>
<tr class="even">
<td colspan="3">Owner’s Name:</td>
<td colspan="10"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="2"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Make:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Style:</td>
<td colspan="2"></td>
<td colspan="2">Year:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="2"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Doors Locked:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Value:</td>
<td colspan="2"></td>
<td colspan="2">Other:</td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| # NARRATIVE                                                           |
+-----------------------------------------------------------------------+
| Victim was delivering a speech at the "Election Extravaganza" event   |
| at the Zenith city conference center when he apparently lost          |
| consciousness. Witness reports he may have had a heart attack.        |
| Ambulance, fire and rescue were dispatched to the scene.              |
+-----------------------------------------------------------------------+

Reporting Officer: [*Off. Avery, Mark*]{.underline}

Supervising Officer: [*Det. Connelly, Daniel*]{.underline}

Reviewing Officer: [*Det. McCarthy, Pamela*]{.underline}