# 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>07-13</em></td>
<td colspan="3" rowspan="2">Time Printed:</td>
<td colspan="3"><em>06:58</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">2</td>
</tr>
<tr class="odd">
<td colspan="2"><h3 id="am">AM</h3></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"><h5 id="arsonfire---911-call">Arson/fire - 911
call</h5></td>
</tr>
<tr class="even">
<td colspan="3">Address of Occurrence:</td>
<td colspan="18"><em>25 Walnut Street</em></td>
</tr>
<tr class="odd">
<td colspan="2">Originally Received As:</td>
<td colspan="5"></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. Strong, Peter</em></td>
<td>Domestic:</td>
<td colspan="2"><em>No</em></td>
</tr>
<tr class="odd">
<td colspan="2">Type of Premises</td>
<td colspan="5"><em>Residence</em></td>
<td colspan="5">Other Offices Notified:</td>
<td colspan="6"><em>28, 17</em></td>
<td>Complaint Status:</td>
<td colspan="2"><em>Outstanding warrant</em></td>
</tr>
<tr class="even">
<td colspan="2">Copies To:</td>
<td colspan="5"><em>Muni Court</em></td>
<td colspan="5">Fire Dept.</td>
<td colspan="6"></td>
<td>Arson Related:</td>
<td colspan="2"><em>Yes</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>07-13</em></td>
<td colspan="3"><em>4:58 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>07-13</em></td>
<td colspan="5">Call Received:</td>
<td colspan="6"><em>05:15 AM</em></td>
<td>Car Number:</td>
<td colspan="2"><em>12</em></td>
</tr>
<tr class="even">
<td colspan="2">Time Reported:</td>
<td colspan="5"><em>05:16 AM</em></td>
<td colspan="5">Time of Arrival:</td>
<td colspan="6"><em>05:25 AM</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>Brown, D.</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"><h5 id="na">N/A</h5></td>
<td colspan="5">Burglary Type:</td>
<td colspan="6"><h5 id="na-1">N/A</h5></td>
<td>Point of Entry Visible to Patrol:</td>
<td colspan="2"><h5 id="no">No</h5></td>
</tr>
<tr class="even">
<td colspan="21"><strong>REPORTING PARTY</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="20"><h5 id="thompson-denise">Thompson, Denise</h5></td>
</tr>
<tr class="even">
<td>Home Address:</td>
<td colspan="20"><em>27 Walnut Street</em></td>
</tr>
<tr class="odd">
<td>Occupation:</td>
<td colspan="20"><em>Housewife</em></td>
</tr>
<tr class="even">
<td>Relation:</td>
<td colspan="20"><em>Neighbor</em></td>
</tr>
<tr class="odd">
<td>SSN:</td>
<td colspan="20"><em>054-89-0058</em></td>
</tr>
<tr class="even">
<td>Date of Birth:</td>
<td colspan="5"><em>10-5</em></td>
<td colspan="3">Sex:</td>
<td colspan="4"><h3 id="female"><em>Female</em></h3></td>
<td colspan="4">Place of Birth:</td>
<td colspan="4"><h5 id="ok">OK</h5></td>
</tr>
<tr class="odd">
<td>Age:</td>
<td colspan="5"><em>41</em></td>
<td colspan="3">Race:</td>
<td colspan="4"><em>Caucasian</em></td>
<td colspan="4">Marital Status:</td>
<td colspan="4"><em>Married</em></td>
</tr>
</tbody>
</table>

+--------+--------+--------+---+---+--------+-----------------------+
| **VI   |        |        |   |   |        |                       |
| CTIM** |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Name:  | ####   |        |   |   |        |                       |
|        | # Smit |        |   |   |        |                       |
|        | h, Joe |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Home   | *25    |        |   |   |        |                       |
| Ad     | Walnut |        |   |   |        |                       |
| dress: | S      |        |   |   |        |                       |
|        | treet* |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Occup  | *UNK*  |        |   |   |        |                       |
| ation: |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Rel    | *Nei   |        |   |   |        |                       |
| ation: | ghbor* |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| SSN:   | *UNK*  |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Date   | ###    | Sex:   | # | F | Place  | *UNK*                 |
| of     | ## UNK |        | # |   | of     |                       |
| Birth: |        |        | # |   | Birth: |                       |
|        |        |        |   |   |        |                       |
|        |        |        | M |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Age:   | *UNK*  | Race:  |   |   | M      | *UNK*                 |
|        |        | Cauc.  |   |   | 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"><h5 id="na-2">N/A</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Date of Birth:</td>
<td></td>
<td colspan="2">Sex:</td>
<td></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>N/A</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"><p id="arson-breaking-entering-unlawful-entry"
class="heading">ARSON, BREAKING &amp; ENTERING, UNLAWFUL ENTRY</p></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>28.12</em></td>
<td colspan="3"><em>4288</em></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="11"></td>
</tr>
<tr class="even">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="even">
<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: 8%" />
<col style="width: 8%" />
<col style="width: 2%" />
<col style="width: 11%" />
<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="14"><h1 id="property">PROPERTY</h1></td>
</tr>
<tr class="even">
<td>Owner’s Name:</td>
<td colspan="13"><h5 id="same-as-above">Same as above</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td colspan="2"></td>
<td>Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td colspan="2"></td>
<td>Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td colspan="2"></td>
<td>Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="14"><h1 id="vehicle">VEHICLE</h1></td>
</tr>
<tr class="odd">
<td colspan="3">Owner’s Name:</td>
<td colspan="11"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Make:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Style:</td>
<td colspan="3"></td>
<td colspan="2">Year:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Doors Locked:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Value:</td>
<td colspan="3"></td>
<td colspan="2">Other:</td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| # NARRATIVE                                                           |
+-----------------------------------------------------------------------+
| *Neighbor believes kids started fire in brush pile of neighbor's      |
| yard. Ladder truck and police officer dispatched.*                    |
+-----------------------------------------------------------------------+

Reporting Officer: [*Off. Strong, Peter*]{.underline}

Supervising Officer: [*Det. Roberts, Bill*]{.underline}

Reviewing Officer: [*Det. Armstrong*]{.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>07-13</em></td>
<td colspan="3" rowspan="2">Time Printed:</td>
<td colspan="3"><em>11:10</em></td>
<td colspan="3" rowspan="2">M.R.S. Number:</td>
<td colspan="2" rowspan="2"><em>1113</em></td>
<td colspan="4" rowspan="2">Record Number</td>
<td rowspan="2">3</td>
</tr>
<tr class="odd">
<td colspan="2"><h3 id="am-1">AM</h3></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"><h5 id="injury-911-call">Injury – 911 call</h5></td>
</tr>
<tr class="even">
<td colspan="3">Address of Occurrence:</td>
<td colspan="18"><em>43 Main St.</em></td>
</tr>
<tr class="odd">
<td colspan="2">Originally Received As:</td>
<td colspan="5"></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"><h4 id="off.-yates-ken"><em>Off. Yates,
Ken</em></h4></td>
<td>Domestic:</td>
<td colspan="2"><em>No</em></td>
</tr>
<tr class="odd">
<td colspan="2">Type of Premises</td>
<td colspan="5"><h5 id="auto-repair-shop">Auto repair shop</h5></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">Fire Dept.</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>07-13</em></td>
<td colspan="3"><em>10:10 A</em></td>
<td colspan="3"></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="2">Date Reported</td>
<td colspan="5"><em>07-13</em></td>
<td colspan="5">Call Received:</td>
<td colspan="6"><em>10:15 AM</em></td>
<td>Car Number:</td>
<td colspan="2"><em>N/A</em></td>
</tr>
<tr class="even">
<td colspan="2">Time Reported:</td>
<td colspan="5"><em>10:16 AM</em></td>
<td colspan="5">Time of Arrival:</td>
<td colspan="6"><em>10:25 AM</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>Brown, D.</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"><h5 id="na-3">N/A</h5></td>
<td colspan="5">Burglary Type:</td>
<td colspan="6"><h5 id="na-4">N/A</h5></td>
<td>Point of Entry Visible to Patrol:</td>
<td colspan="2"><h5 id="no-1">No</h5></td>
</tr>
<tr class="even">
<td colspan="21"><strong>REPORTING PARTY</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="20"><h5 id="roux-timothy">Roux, Timothy</h5></td>
</tr>
<tr class="even">
<td>Home Address:</td>
<td colspan="20"><em>30 Farnham Road</em></td>
</tr>
<tr class="odd">
<td>Occupation:</td>
<td colspan="20"><em>Auto mechanic</em></td>
</tr>
<tr class="even">
<td>Relation:</td>
<td colspan="20"><em>Boss</em></td>
</tr>
<tr class="odd">
<td>SSN:</td>
<td colspan="20"><em>159-15-4589</em></td>
</tr>
<tr class="even">
<td>Date of Birth:</td>
<td colspan="5"><em>04-23</em></td>
<td colspan="3">Sex:</td>
<td colspan="4"><h3 id="male"><em>Male</em></h3></td>
<td colspan="4">Place of Birth:</td>
<td colspan="4"><h5 id="ca">CA</h5></td>
</tr>
<tr class="odd">
<td>Age:</td>
<td colspan="5"><em>41</em></td>
<td colspan="3">Race:</td>
<td colspan="4"><em>Caucasian</em></td>
<td colspan="4">Marital Status:</td>
<td colspan="4"><em>Married</em></td>
</tr>
</tbody>
</table>

+--------+--------+--------+---+---+--------+-----------------------+
| **VI   |        |        |   |   |        |                       |
| CTIM** |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Name:  | #####  |        |   |   |        |                       |
|        | Smith, |        |   |   |        |                       |
|        |  Jared |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Home   | *106   |        |   |   |        |                       |
| Ad     | Beach  |        |   |   |        |                       |
| dress: | St.*   |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Occup  | *Auto  |        |   |   |        |                       |
| ation: | mec    |        |   |   |        |                       |
|        | hanic* |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Rel    | *Emp   |        |   |   |        |                       |
| ation: | loyee* |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| SSN:   | *UNK*  |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Date   | *UNK*  | Sex:   | * | F | Place  | *UNK*                 |
| of     |        |        | * |   | of     |                       |
| Birth: |        |        | M |   | Birth: |                       |
|        |        |        | * |   |        |                       |
|        |        |        | * |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Age:   | *27*   | Race:  |   |   | M      | *single*              |
|        |        | Cauc.  |   |   | 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"><h5 id="na-5">N/A</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Date of Birth:</td>
<td></td>
<td colspan="2">Sex:</td>
<td></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>N/A</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"></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="11"></td>
</tr>
<tr class="even">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="odd">
<td colspan="11"><strong>KNOWN SUSPECT #3</strong></td>
</tr>
<tr class="even">
<td>Name:</td>
<td colspan="10"></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="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="even">
<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: 8%" />
<col style="width: 8%" />
<col style="width: 2%" />
<col style="width: 11%" />
<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="14"><h1 id="property-1">PROPERTY</h1></td>
</tr>
<tr class="even">
<td>Owner’s Name:</td>
<td colspan="13"><h5 id="same-as-above-1">Same as above</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td colspan="2"></td>
<td>Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td colspan="2"></td>
<td>Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td colspan="2"></td>
<td>Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="14"><h1 id="vehicle-1">VEHICLE</h1></td>
</tr>
<tr class="odd">
<td colspan="3">Owner’s Name:</td>
<td colspan="11"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Make:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Style:</td>
<td colspan="3"></td>
<td colspan="2">Year:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Doors Locked:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Value:</td>
<td colspan="3"></td>
<td colspan="2">Other:</td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| # NARRATIVE                                                           |
+-----------------------------------------------------------------------+
| *Mr. Roux says that Mr. Smith's arm was crushed in a hydraulic lift   |
| at the shop. Mr. Smith keeps going in and out of consciousness.       |
| Ambulance dispatched.*                                                |
+-----------------------------------------------------------------------+

Reporting Officer: [*Off. Yates, Ken*]{.underline}

Supervising Officer: [*Det. Rollins, Michael*]{.underline}

Reviewing Officer: [*Det. Foster, Kristen*]{.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>07-14</em></td>
<td colspan="3" rowspan="2">Time Printed:</td>
<td colspan="3"><em>06:22</em></td>
<td colspan="3" rowspan="2">M.R.S. Number:</td>
<td colspan="2" rowspan="2"><em>1114</em></td>
<td colspan="4" rowspan="2">Record Number</td>
<td rowspan="2">1</td>
</tr>
<tr class="odd">
<td colspan="2"><h3 id="am-2">AM</h3></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"><h5 id="arsonfire--911-call">Arson/fire- 911
call</h5></td>
</tr>
<tr class="even">
<td colspan="3">Address of Occurrence:</td>
<td colspan="18"><em>310 Magnolia Road</em></td>
</tr>
<tr class="odd">
<td colspan="2">Originally Received As:</td>
<td colspan="5"></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. Roche, Marie</em></td>
<td>Domestic:</td>
<td colspan="2"><h5 id="no-2">No</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Type of Premises</td>
<td colspan="5"><h5 id="unfinished-residence">Unfinished
residence</h5></td>
<td colspan="5">Other Offices Notified:</td>
<td colspan="6"><em>31, 77</em></td>
<td>Complaint Status:</td>
<td colspan="2"><em>Outstanding warrant</em></td>
</tr>
<tr class="even">
<td colspan="2">Copies To:</td>
<td colspan="5"><em>Muni Court</em></td>
<td colspan="5">Fire Dept.</td>
<td colspan="6"></td>
<td>Arson Related:</td>
<td colspan="2"><em>Yes</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>07-14</em></td>
<td colspan="3"><em>01:22 AM</em></td>
<td colspan="3"><em>07-14-03</em></td>
<td colspan="3"><em>05:28</em></td>
</tr>
<tr class="odd">
<td colspan="2">Date Reported</td>
<td colspan="5"><em>07-14</em></td>
<td colspan="5">Call Received:</td>
<td colspan="6"><em>01:01 AM</em></td>
<td>Car Number:</td>
<td colspan="2"><em>9</em></td>
</tr>
<tr class="even">
<td colspan="2">Time Reported:</td>
<td colspan="5"><em>01:22 AM</em></td>
<td colspan="5">Time of Arrival:</td>
<td colspan="6"><em>01:25 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>Brown, D.</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"><h5 id="unlawful-entry">Unlawful entry</h5></td>
<td colspan="5">Burglary Type: N/A</td>
<td colspan="6"><em>Night (6 PM –6 AM)</em></td>
<td>Point of Entry Visible to Patrol:</td>
<td colspan="2"><h5 id="no-3">No</h5></td>
</tr>
<tr class="even">
<td colspan="21"><strong>REPORTING PARTY</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="20"><h5 id="bill-burnham">Bill Burnham</h5></td>
</tr>
<tr class="even">
<td>Home Address:</td>
<td colspan="20"><em>312 Magnolia Road</em></td>
</tr>
<tr class="odd">
<td>Occupation:</td>
<td colspan="20"><em>Builder</em></td>
</tr>
<tr class="even">
<td>Relation:</td>
<td colspan="20"><em>Neighbor</em></td>
</tr>
<tr class="odd">
<td>SSN:</td>
<td colspan="20"><em>123-12-1236</em></td>
</tr>
<tr class="even">
<td>Date of Birth:</td>
<td colspan="5"><em>01-11</em></td>
<td colspan="3">Sex:</td>
<td colspan="4"><h3 id="male-1"><em>Male</em></h3></td>
<td colspan="4">Place of Birth:</td>
<td colspan="4"><h5 id="ma">MA</h5></td>
</tr>
<tr class="odd">
<td>Age:</td>
<td colspan="5"><em>54</em></td>
<td colspan="3">Race:</td>
<td colspan="4"><em>Caucasian</em></td>
<td colspan="4">Marital Status:</td>
<td colspan="4"><em>Divorced</em></td>
</tr>
</tbody>
</table>

+--------+--------+--------+---+---+--------+-----------------------+
| **VI   |        |        |   |   |        |                       |
| CTIM** |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Name:  | ##     |        |   |   |        |                       |
|        | ### Sa |        |   |   |        |                       |
|        | me as  |        |   |   |        |                       |
|        | above  |        |   |   |        |                       |
|        | {#same |        |   |   |        |                       |
|        | -as-ab |        |   |   |        |                       |
|        | ove-2} |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| 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"><h5 id="na-6">N/A</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Date of Birth:</td>
<td><em>N/A</em></td>
<td colspan="2">Sex:</td>
<td></td>
<td colspan="2">Age:</td>
<td></td>
<td>Race:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Height:</td>
<td><em>6’-0”</em></td>
<td colspan="2">Hair Color:</td>
<td>Brown</td>
<td colspan="3">Injured:</td>
<td colspan="2"><h5 id="no-4">No</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Weight:</td>
<td><em>180</em></td>
<td colspan="2">Hair Length:</td>
<td>Long</td>
<td colspan="3">Hospital:</td>
<td colspan="2"><em>N/A</em></td>
</tr>
<tr class="even">
<td colspan="2">Build:</td>
<td><h5 id="medium">Medium</h5></td>
<td colspan="2">Hair Style:</td>
<td><h5 id="curly-and-long">Curly and long</h5></td>
<td colspan="3">Hospital Disposition:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Complexion:</td>
<td><em>Dark</em></td>
<td colspan="2">Facial Hair:</td>
<td><em>Beard</em></td>
<td colspan="3">Conveyed By:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Eye Color:</td>
<td><em>Dark</em></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"><p id="arson-unlawful-entry" class="heading">ARSON,
UNLAWFUL ENTRY</p></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>28.12</em></td>
<td colspan="3"><em>4288</em></td>
<td colspan="4"><em>-</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="11"></td>
</tr>
<tr class="even">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</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>
</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: 8%" />
<col style="width: 8%" />
<col style="width: 2%" />
<col style="width: 11%" />
<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="14"><h1 id="property-2">PROPERTY</h1></td>
</tr>
<tr class="even">
<td>Owner’s Name:</td>
<td colspan="13"></td>
</tr>
<tr class="odd">
<td colspan="2">Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td colspan="2"></td>
<td>Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td colspan="2"></td>
<td>Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td colspan="2"></td>
<td>Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="14"><h1 id="vehicle-2">VEHICLE</h1></td>
</tr>
<tr class="odd">
<td colspan="3">Owner’s Name:</td>
<td colspan="11"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Make:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Style:</td>
<td colspan="3"></td>
<td colspan="2">Year:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Doors Locked:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Value:</td>
<td colspan="3"></td>
<td colspan="2">Other:</td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| # NARRATIVE                                                           |
+-----------------------------------------------------------------------+
| *Witness observed middle aged man exiting unfinished residence where  |
| fire occurred carrying small box and bucket, moving rapidly but not   |
| running; dark complexion, beard; FD identified matches and            |
| combustible fluid as source of fire; may be related to fire on 07-13  |
| on Walnut Street; investigations ongoing. Residence set on fire is    |
| being built by Mr. Burnham.*                                          |
+-----------------------------------------------------------------------+

Reporting Officer: [*Off. Roche, M.*]{.underline}

Supervising Officer: [*Off, Henry, J.K.*]{.underline}

Reviewing Officer: [*Det. Stills*]{.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>07-14</em></td>
<td colspan="3" rowspan="2">Time Printed:</td>
<td colspan="3"><em>09:20</em></td>
<td colspan="3" rowspan="2">M.R.S. Number:</td>
<td colspan="2" rowspan="2"><em>1115</em></td>
<td colspan="4" rowspan="2">Record Number</td>
<td rowspan="2">2</td>
</tr>
<tr class="odd">
<td colspan="2"><h3 id="am-3">AM</h3></td>
<td><h3 id="pm-3">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"><h5 id="injury-911-call-1">Injury – 911 call</h5></td>
</tr>
<tr class="even">
<td colspan="3">Address of Occurrence:</td>
<td colspan="18"><em>24 Eisenhower Dr.</em></td>
</tr>
<tr class="odd">
<td colspan="2">Originally Received As:</td>
<td colspan="5"></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. Sanchez, Frank</em></td>
<td>Domestic:</td>
<td colspan="2"><em>No</em></td>
</tr>
<tr class="odd">
<td colspan="2">Type of Premises</td>
<td colspan="5"><em>Residence</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">Fire Dept.</td>
<td colspan="6"></td>
<td>Arson Related:</td>
<td colspan="2"><h5 id="no-5">No</h5></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>07-14</em></td>
<td colspan="3"><em>8:20 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>07-14</em></td>
<td colspan="5">Call Received:</td>
<td colspan="6"><em>8:20 AM</em></td>
<td>Car Number:</td>
<td colspan="2"><em>N/A</em></td>
</tr>
<tr class="even">
<td colspan="2">Time Reported:</td>
<td colspan="5"><em>08:20 AM</em></td>
<td colspan="5">Time of Arrival:</td>
<td colspan="6"><em>8:30 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>Brown, D.</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"><h5 id="na-7">N/A</h5></td>
<td colspan="5">Burglary Type:</td>
<td colspan="6"><h5 id="na-8">N/A</h5></td>
<td>Point of Entry Visible to Patrol:</td>
<td colspan="2"><h5 id="no-6">No</h5></td>
</tr>
<tr class="even">
<td colspan="21"><strong>REPORTING PARTY</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="20"><h5 id="wellington-sandra">Wellington, Sandra</h5></td>
</tr>
<tr class="even">
<td>Home Address:</td>
<td colspan="20"><em>Same as above</em></td>
</tr>
<tr class="odd">
<td>Occupation:</td>
<td colspan="20"><em>Bank teller</em></td>
</tr>
<tr class="even">
<td>Relation:</td>
<td colspan="20"><em>Victim</em></td>
</tr>
<tr class="odd">
<td>SSN:</td>
<td colspan="20"><em>154-89-3495</em></td>
</tr>
<tr class="even">
<td>Date of Birth:</td>
<td colspan="5"><em>03-03</em></td>
<td colspan="3">Sex:</td>
<td colspan="4"><h3 id="female-1"><em>Female</em></h3></td>
<td colspan="4">Place of Birth:</td>
<td colspan="4"><h5 id="ky">KY</h5></td>
</tr>
<tr class="odd">
<td>Age:</td>
<td colspan="5"><em>33</em></td>
<td colspan="3">Race:</td>
<td colspan="4"><em>Caucasian</em></td>
<td colspan="4">Marital Status:</td>
<td colspan="4"><em>Single</em></td>
</tr>
</tbody>
</table>

+--------+--------+--------+---+---+--------+-----------------------+
| **VI   |        |        |   |   |        |                       |
| CTIM** |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Name:  | ##     |        |   |   |        |                       |
|        | ### Sa |        |   |   |        |                       |
|        | me as  |        |   |   |        |                       |
|        | above  |        |   |   |        |                       |
|        | {#same |        |   |   |        |                       |
|        | -as-ab |        |   |   |        |                       |
|        | ove-3} |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| 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"><h5 id="na-9">N/A</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Date of Birth:</td>
<td></td>
<td colspan="2">Sex:</td>
<td></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>N/A</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"></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="11"></td>
</tr>
<tr class="even">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</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: 8%" />
<col style="width: 8%" />
<col style="width: 2%" />
<col style="width: 11%" />
<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="14"><h1 id="property-3">PROPERTY</h1></td>
</tr>
<tr class="even">
<td>Owner’s Name:</td>
<td colspan="13"><h5 id="same-as-above-4">Same as above</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td colspan="2"></td>
<td>Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td colspan="2"></td>
<td>Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td colspan="2"></td>
<td>Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="14"><h1 id="vehicle-3">VEHICLE</h1></td>
</tr>
<tr class="odd">
<td colspan="3">Owner’s Name:</td>
<td colspan="11"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Make:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Style:</td>
<td colspan="3"></td>
<td colspan="2">Year:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Doors Locked:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Value:</td>
<td colspan="3"></td>
<td colspan="2">Other:</td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| # NARRATIVE                                                           |
+-----------------------------------------------------------------------+
| *Ms. Wellington says she accidentally tripped and fell down some      |
| concrete stairs outside of her home. She is in great pain and thinks  |
| she broke her leg. Ambulance dispatched.*                             |
+-----------------------------------------------------------------------+

Reporting Officer: [*Off. Sanchez, Frank*]{.underline}

Supervising Officer: [*Det. Roberts, Bill*]{.underline}

Reviewing Officer: [*Det. Armstrong*]{.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-4">INCIDENT
DATE/TIME</h1></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2">Date Printed:</td>
<td colspan="2" rowspan="2"><em>07-15</em></td>
<td colspan="3" rowspan="2">Time Printed:</td>
<td colspan="3"><em>03:10</em></td>
<td colspan="3" rowspan="2">M.R.S. Number:</td>
<td colspan="2" rowspan="2"><em>1117</em></td>
<td colspan="4" rowspan="2">Record Number</td>
<td rowspan="2">1</td>
</tr>
<tr class="odd">
<td colspan="2">AM</td>
<td><h3 id="pm-4">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"><h5 id="animal-complaint-911-call">Animal complaint –
911 call</h5></td>
</tr>
<tr class="even">
<td colspan="3">Address of Occurrence:</td>
<td colspan="18"><em>3 Capen Hill Rd.</em></td>
</tr>
<tr class="odd">
<td colspan="2">Originally Received As:</td>
<td colspan="5"></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"><h5 id="off.-strong-peter">Off. Strong, Peter </h5></td>
<td>Domestic:</td>
<td colspan="2"><h5 id="no-7">No</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Type of Premises</td>
<td colspan="5"><em>Residence</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">Fire Dept.</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>07-15</em></td>
<td colspan="3"><em>1:10 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>07-15</em></td>
<td colspan="5">Call Received:</td>
<td colspan="6"><em>1:30 PM</em></td>
<td>Car Number:</td>
<td colspan="2"><em>ACU</em></td>
</tr>
<tr class="even">
<td colspan="2">Time Reported:</td>
<td colspan="5"><em>01:30 PM</em></td>
<td colspan="5">Time of Arrival:</td>
<td colspan="6"><em>2:15 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>Brown, D.</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"><h5 id="na-10">N/A</h5></td>
<td colspan="5">Burglary Type:</td>
<td colspan="6"><h5 id="na-11">N/A</h5></td>
<td>Point of Entry Visible to Patrol:</td>
<td colspan="2"><h5 id="no-8">No</h5></td>
</tr>
<tr class="even">
<td colspan="21"><strong>REPORTING PARTY</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="20"><h5 id="felds-kathy">Felds, Kathy</h5></td>
</tr>
<tr class="even">
<td>Home Address:</td>
<td colspan="20"><em>Same as above</em></td>
</tr>
<tr class="odd">
<td>Occupation:</td>
<td colspan="20"><em>Housewife</em></td>
</tr>
<tr class="even">
<td>Relation:</td>
<td colspan="20"></td>
</tr>
<tr class="odd">
<td>SSN:</td>
<td colspan="20"><em>245-51-6189</em></td>
</tr>
<tr class="even">
<td>Date of Birth:</td>
<td colspan="5"><em>07-11</em></td>
<td colspan="3">Sex:</td>
<td colspan="4"><h3 id="female-2"><em>Female</em></h3></td>
<td colspan="4">Place of Birth:</td>
<td colspan="4"><h5 id="il">IL</h5></td>
</tr>
<tr class="odd">
<td>Age:</td>
<td colspan="5"><em>43</em></td>
<td colspan="3">Race:</td>
<td colspan="4"><em>Black</em></td>
<td colspan="4">Marital Status:</td>
<td colspan="4"><em>Married</em></td>
</tr>
</tbody>
</table>

+--------+--------+--------+---+---+--------+-----------------------+
| **VI   |        |        |   |   |        |                       |
| CTIM** |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Name:  | ##     |        |   |   |        |                       |
|        | ### Sa |        |   |   |        |                       |
|        | me as  |        |   |   |        |                       |
|        | above  |        |   |   |        |                       |
|        | {#same |        |   |   |        |                       |
|        | -as-ab |        |   |   |        |                       |
|        | ove-5} |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| 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"><h5 id="na-12">N/A</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Date of Birth:</td>
<td></td>
<td colspan="2">Sex:</td>
<td></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>N/A</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"></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="11"></td>
</tr>
<tr class="even">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</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: 8%" />
<col style="width: 8%" />
<col style="width: 2%" />
<col style="width: 11%" />
<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="14"><h1 id="property-4">PROPERTY</h1></td>
</tr>
<tr class="even">
<td>Owner’s Name:</td>
<td colspan="13"><h5 id="same-as-above-6">Same as above</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td colspan="2"></td>
<td>Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td colspan="2"></td>
<td>Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td colspan="2"></td>
<td>Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="14"><h1 id="vehicle-4">VEHICLE</h1></td>
</tr>
<tr class="odd">
<td colspan="3">Owner’s Name:</td>
<td colspan="11"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Make:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Style:</td>
<td colspan="3"></td>
<td colspan="2">Year:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Doors Locked:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Value:</td>
<td colspan="3"></td>
<td colspan="2">Other:</td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| # NARRATIVE                                                           |
+-----------------------------------------------------------------------+
| *Mrs. Felds says there is a raccoon in her yard behaving strangely.   |
| She has been observing it for about 20 minutes and is concerned it is |
| rabid or sick. Animal Control notified to dispatch ACU to her         |
| location.*                                                            |
+-----------------------------------------------------------------------+

Reporting Officer: [*Off. Strong, Peter*]{.underline}

Supervising Officer: [*Det. Roberts, Bill*]{.underline}

Reviewing Officer: [*Det. Armstrong*]{.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-5">INCIDENT
DATE/TIME</h1></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2">Date Printed:</td>
<td colspan="2" rowspan="2"><em>07-16</em></td>
<td colspan="3" rowspan="2">Time Printed:</td>
<td colspan="3"><em>04:10</em></td>
<td colspan="3" rowspan="2">M.R.S. Number:</td>
<td colspan="2" rowspan="2"><em>1120</em></td>
<td colspan="4" rowspan="2">Record Number</td>
<td rowspan="2">2</td>
</tr>
<tr class="odd">
<td colspan="2">AM</td>
<td><h3 id="pm-5">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"><h5 id="lost-pet-911-call">Lost pet – 911
call</h5></td>
</tr>
<tr class="even">
<td colspan="3">Address of Occurrence:</td>
<td colspan="18"><em>12 Williams Rd.</em></td>
</tr>
<tr class="odd">
<td colspan="2">Originally Received As:</td>
<td colspan="5"></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"><em>No</em></td>
</tr>
<tr class="odd">
<td colspan="2">Type of Premises</td>
<td colspan="5"><em>Residence</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">Fire Dept.</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>07-16</em></td>
<td colspan="3"><em>2:10 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>07-16</em></td>
<td colspan="5">Call Received:</td>
<td colspan="6"><em>2:30 PM</em></td>
<td>Car Number:</td>
<td colspan="2"><em>Ladder Truck 1</em></td>
</tr>
<tr class="even">
<td colspan="2">Time Reported:</td>
<td colspan="5"><em>02:30 PM</em></td>
<td colspan="5">Time of Arrival:</td>
<td colspan="6"><em>3:00 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>Brown, D.</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"><h5 id="na-13">N/A</h5></td>
<td colspan="5">Burglary Type:</td>
<td colspan="6"><h5 id="na-14">N/A</h5></td>
<td>Point of Entry Visible to Patrol:</td>
<td colspan="2"><h5 id="no-9">No</h5></td>
</tr>
<tr class="even">
<td colspan="21"><strong>REPORTING PARTY</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="20"><h5 id="ward-georgina">Ward, Georgina</h5></td>
</tr>
<tr class="even">
<td>Home Address:</td>
<td colspan="20"><em>Same as above</em></td>
</tr>
<tr class="odd">
<td>Occupation:</td>
<td colspan="20"><em>Housewife</em></td>
</tr>
<tr class="even">
<td>Relation:</td>
<td colspan="20"></td>
</tr>
<tr class="odd">
<td>SSN:</td>
<td colspan="20"><em>456-19-3485</em></td>
</tr>
<tr class="even">
<td>Date of Birth:</td>
<td colspan="5"><em>06-12</em></td>
<td colspan="3">Sex:</td>
<td colspan="4"><h3 id="female-3"><em>Female</em></h3></td>
<td colspan="4">Place of Birth:</td>
<td colspan="4"><h5 id="mi"> MI</h5></td>
</tr>
<tr class="odd">
<td>Age:</td>
<td colspan="5"><em>54</em></td>
<td colspan="3">Race:</td>
<td colspan="4"><em>Caucasian</em></td>
<td colspan="4">Marital Status:</td>
<td colspan="4"><em>Married</em></td>
</tr>
</tbody>
</table>

+--------+--------+--------+---+---+--------+-----------------------+
| **VI   |        |        |   |   |        |                       |
| CTIM** |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Name:  | ##     |        |   |   |        |                       |
|        | ### Sa |        |   |   |        |                       |
|        | me as  |        |   |   |        |                       |
|        | above  |        |   |   |        |                       |
|        | {#same |        |   |   |        |                       |
|        | -as-ab |        |   |   |        |                       |
|        | ove-7} |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| 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"><h5 id="na-15">N/A</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Date of Birth:</td>
<td></td>
<td colspan="2">Sex:</td>
<td></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>N/A</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"></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="11"></td>
</tr>
<tr class="even">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</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: 8%" />
<col style="width: 8%" />
<col style="width: 2%" />
<col style="width: 12%" />
<col style="width: 1%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 5%" />
<col style="width: 11%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="14"><h1 id="property-5">PROPERTY</h1></td>
</tr>
<tr class="even">
<td>Owner’s Name:</td>
<td colspan="13"><h5 id="same-as-above-8">Same as above</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td colspan="2"></td>
<td>Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td colspan="2"></td>
<td>Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td colspan="2"></td>
<td>Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="14"><h1 id="vehicle-5">VEHICLE</h1></td>
</tr>
<tr class="odd">
<td colspan="3">Owner’s Name:</td>
<td colspan="11"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Make:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Style:</td>
<td colspan="3"></td>
<td colspan="2">Year:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Doors Locked:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Value:</td>
<td colspan="3"></td>
<td colspan="2">Other:</td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| # NARRATIVE                                                           |
+-----------------------------------------------------------------------+
| *Mrs. Ward is very distressed that her cat, "Cuddles," escaped from   |
| the house and is now stuck up in a large oak tree in the front yard.  |
| Fire Dept. notified. Mrs. Ward advised to call normal business line   |
| in future for calls of this nature.*                                  |
+-----------------------------------------------------------------------+

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-6">INCIDENT
DATE/TIME</h1></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2">Date Printed:</td>
<td colspan="2" rowspan="2"><em>07-16</em></td>
<td colspan="3" rowspan="2">Time Printed:</td>
<td colspan="3"><em>11:58</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">3</td>
</tr>
<tr class="odd">
<td colspan="2">AM</td>
<td><h3 id="pm-6">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"><h5
id="aggravated-assault-assault-on-a-police-officer-911-call">Aggravated
assault, assault on a police officer – 911 call</h5></td>
</tr>
<tr class="even">
<td colspan="3">Address of Occurrence:</td>
<td colspan="18"><em>678 Main Street</em></td>
</tr>
<tr class="odd">
<td colspan="2">Originally Received As:</td>
<td colspan="5"><h5 id="phone-in">Phone in</h5></td>
<td colspan="5">Weapon or Objects Used:</td>
<td colspan="6"><em>-</em></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. Pursinger, Ben</em></td>
<td>Domestic:</td>
<td colspan="2"><em>No</em></td>
</tr>
<tr class="odd">
<td colspan="2">Type of Premises</td>
<td colspan="5"><em>Parking lot</em></td>
<td colspan="5">Other Offices Notified:</td>
<td colspan="6"><em>-</em></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"><em>Muni Court</em></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>07-16</em></td>
<td colspan="3"><em>11:28 PM</em></td>
<td colspan="3"><em>07-17</em></td>
<td colspan="3"><em>12:15 PM</em></td>
</tr>
<tr class="odd">
<td colspan="2">Date Reported</td>
<td colspan="5"><em>07-16</em></td>
<td colspan="5">Call Received:</td>
<td colspan="6"><em>11:33 PM</em></td>
<td>Car Number:</td>
<td colspan="2"><em>44</em></td>
</tr>
<tr class="even">
<td colspan="2">Time Reported:</td>
<td colspan="5"><em>11:33 PM</em></td>
<td colspan="5">Time of Arrival:</td>
<td colspan="6"><em>11:36 PM</em></td>
<td>District:</td>
<td colspan="2"><em>The Village</em></td>
</tr>
<tr class="odd">
<td colspan="2">Officer Assaulted or Killed:</td>
<td colspan="5"><em>Yes</em></td>
<td colspan="5">GEO Code:</td>
<td colspan="6"><em>33</em></td>
<td>Processed By:</td>
<td colspan="2"><em>Brown, D.</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"></td>
<td colspan="5">Burglary Type: N/A</td>
<td colspan="6"></td>
<td>Point of Entry Visible to Patrol:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="21"><strong>REPORTING PARTY</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="20"><h5 id="khalsa-singh-vidu">Khalsa, Singh Vidu</h5></td>
</tr>
<tr class="even">
<td>Home Address:</td>
<td colspan="20"><em>34 Reeves Road</em></td>
</tr>
<tr class="odd">
<td>Occupation:</td>
<td colspan="20"><em>Dishwasher</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>234-45-6789</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="4"><h3 id="male-2"><em>Male</em></h3></td>
<td colspan="4">Place of Birth:</td>
<td colspan="4"><h5 id="india">India</h5></td>
</tr>
<tr class="odd">
<td>Age:</td>
<td colspan="5"><em>43</em></td>
<td colspan="3">Race:</td>
<td colspan="4"><em>East Indian</em></td>
<td colspan="4">Marital Status:</td>
<td colspan="4"><em>Married</em></td>
</tr>
</tbody>
</table>

+--------+--------+--------+---+---+--------+-----------------------+
| **VI   |        |        |   |   |        |                       |
| CTIM** |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Name:  | ##     |        |   |   |        |                       |
|        | ### Sa |        |   |   |        |                       |
|        | me as  |        |   |   |        |                       |
|        | above  |        |   |   |        |                       |
|        | {#same |        |   |   |        |                       |
|        | -as-ab |        |   |   |        |                       |
|        | ove-9} |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| 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"><h5 id="mohammed-achmed">Mohammed, Achmed</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Date of Birth:</td>
<td><em>08-23</em></td>
<td colspan="2">Sex:</td>
<td><h5 id="male-3">Male</h5></td>
<td colspan="2">Age:</td>
<td><em>42</em></td>
<td>Race:</td>
<td><h5 id="other">Other</h5></td>
</tr>
<tr class="even">
<td colspan="2">Height:</td>
<td><em>5’-10”</em></td>
<td colspan="2">Hair Color:</td>
<td><em>Black</em></td>
<td colspan="3">Injured:</td>
<td colspan="2"><h5 id="no-10">No</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Weight:</td>
<td><em>165</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><h5 id="medium-1">Medium</h5></td>
<td colspan="2">Hair Style:</td>
<td><h5 id="short">Short</h5></td>
<td colspan="3">Hospital Disposition:</td>
<td colspan="2"><em>No</em></td>
</tr>
<tr class="odd">
<td colspan="2">Complexion:</td>
<td><em>Dark</em></td>
<td colspan="2">Facial Hair:</td>
<td><em>Yes, beard</em></td>
<td colspan="3">Conveyed By:</td>
<td colspan="2"><em>N/A</em></td>
</tr>
<tr class="even">
<td colspan="2">Eye Color:</td>
<td><em>Brown</em></td>
<td colspan="2">AR#:</td>
<td><em>34</em></td>
<td colspan="3">Injury Type:</td>
<td colspan="2"><em>Broken jaw</em></td>
</tr>
<tr class="odd">
<td colspan="11">CHARGES</td>
</tr>
<tr class="even">
<td colspan="11"><p
id="aggravated-assault-assault-upon-a-police-officer"
class="heading">AGGRAVATED ASSAULT, ASSAULT UPON A POLICE
OFFICER</p></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>456.98</em></td>
<td colspan="3"><em>333</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: Male</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="11"></td>
</tr>
<tr class="even">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</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="11"></td>
</tr>
<tr class="even">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</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: 8%" />
<col style="width: 8%" />
<col style="width: 2%" />
<col style="width: 12%" />
<col style="width: 1%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 5%" />
<col style="width: 11%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="14"><h1 id="property-6">PROPERTY</h1></td>
</tr>
<tr class="even">
<td>Owner’s Name:</td>
<td colspan="13"></td>
</tr>
<tr class="odd">
<td colspan="2">Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td colspan="2"></td>
<td>Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td colspan="2"></td>
<td>Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td colspan="2"></td>
<td>Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="14"><h1 id="vehicle-6">VEHICLE</h1></td>
</tr>
<tr class="odd">
<td colspan="3">Owner’s Name:</td>
<td colspan="11"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Make:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Style:</td>
<td colspan="3"></td>
<td colspan="2">Year:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Doors Locked:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Value:</td>
<td colspan="3"></td>
<td colspan="2">Other:</td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| # NARRATIVE                                                           |
+-----------------------------------------------------------------------+
| *Suspect arrested for attacking coworker and breaking his jaw;        |
| suspect fought with police, resisted arrest and struck police officer |
| complaining of "oppression by the boss" and promising revenge; victim |
| taken to hospital.*                                                   |
+-----------------------------------------------------------------------+

Reporting Officer: [*Off. Pursinger, Ben*]{.underline}

Supervising Officer: [*Off, Black, Joe*]{.underline}

Reviewing Officer: [*Det. Manly*]{.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-7">INCIDENT
DATE/TIME</h1></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2">Date Printed:</td>
<td colspan="2" rowspan="2"><em>07-17</em></td>
<td colspan="3" rowspan="2">Time Printed:</td>
<td colspan="3"><em>08:57</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"><h3 id="am-4">AM</h3></td>
<td><h3 id="pm-7">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"><h5 id="traffic-accident-911-call">Traffic accident –
911 call</h5></td>
</tr>
<tr class="even">
<td colspan="3">Address of Occurrence:</td>
<td colspan="18"><em>205 Main St.</em></td>
</tr>
<tr class="odd">
<td colspan="2">Originally Received As:</td>
<td colspan="5"></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. Kerry, Mark</em></td>
<td>Domestic:</td>
<td colspan="2"><em>No</em></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"></td>
</tr>
<tr class="even">
<td colspan="2">Copies To:</td>
<td colspan="5"><em>Muni court</em></td>
<td colspan="5">Fire Dept.</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">07-17</td>
<td colspan="3"><em>8:37 AM</em></td>
<td colspan="3"></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="2">Date Reported</td>
<td colspan="5">07-17</td>
<td colspan="5">Call Received:</td>
<td colspan="6"><em>8:38 AM</em></td>
<td>Car Number:</td>
<td colspan="2"><em>11</em></td>
</tr>
<tr class="even">
<td colspan="2">Time Reported:</td>
<td colspan="5">08:38 AM</td>
<td colspan="5">Time of Arrival:</td>
<td colspan="6"><em>8: 46 AM</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">No</td>
<td colspan="5">GEO Code:</td>
<td colspan="6"><em>55</em></td>
<td>Processed By:</td>
<td colspan="2"><em>Brown, D.</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"><h5 id="na-16">N/A</h5></td>
<td colspan="5">Burglary Type:</td>
<td colspan="6"><h5 id="na-17">N/A</h5></td>
<td>Point of Entry Visible to Patrol:</td>
<td colspan="2"><h5 id="no-11">No</h5></td>
</tr>
<tr class="even">
<td colspan="21"><strong>REPORTING PARTY</strong></td>
</tr>
<tr class="odd">
<td>Name:</td>
<td colspan="20"><h5 id="johnson-christina">Johnson, Christina</h5></td>
</tr>
<tr class="even">
<td>Home Address:</td>
<td colspan="20"><em>19 Heather Way</em></td>
</tr>
<tr class="odd">
<td>Occupation:</td>
<td colspan="20"><em>Sales associate</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>159-45-1679</em></td>
</tr>
<tr class="even">
<td>Date of Birth:</td>
<td colspan="5"><em>02-28</em></td>
<td colspan="3">Sex:</td>
<td colspan="4"><h3 id="female-4"><em>Female</em></h3></td>
<td colspan="4">Place of Birth:</td>
<td colspan="4"><h5 id="mi-1"> MI</h5></td>
</tr>
<tr class="odd">
<td>Age:</td>
<td colspan="5"><em>23</em></td>
<td colspan="3">Race:</td>
<td colspan="4"><em>Caucasian</em></td>
<td colspan="4">Marital Status:</td>
<td colspan="4"><em>Single</em></td>
</tr>
</tbody>
</table>

+--------+--------+--------+---+---+--------+-----------------------+
| **VI   |        |        |   |   |        |                       |
| CTIM** |        |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| Name:  | ###    |        |   |   |        |                       |
|        | ## UNK |        |   |   |        |                       |
+--------+--------+--------+---+---+--------+-----------------------+
| 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"><h5 id="na-18">N/A</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Date of Birth:</td>
<td></td>
<td colspan="2">Sex:</td>
<td></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>N/A</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"></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="11"></td>
</tr>
<tr class="even">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</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="11"></td>
</tr>
<tr class="even">
<td colspan="4">RSMO USC</td>
<td colspan="3">MO Code</td>
<td colspan="4">F/M/C</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: 8%" />
<col style="width: 8%" />
<col style="width: 2%" />
<col style="width: 11%" />
<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="14"><h1 id="property-7">PROPERTY</h1></td>
</tr>
<tr class="even">
<td>Owner’s Name:</td>
<td colspan="13"><h5 id="same-as-above-10">Same as above</h5></td>
</tr>
<tr class="odd">
<td colspan="2">Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td colspan="2"></td>
<td>Item #:</td>
<td colspan="2"></td>
<td colspan="2">Value:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td colspan="2"></td>
<td>Quantity:</td>
<td colspan="2"></td>
<td colspan="2">Status:</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td colspan="2"></td>
<td>Property Description:</td>
<td colspan="2"></td>
<td colspan="2">Owner’s Name:</td>
<td></td>
</tr>
<tr class="even">
<td colspan="14"><h1 id="vehicle-7">VEHICLE</h1></td>
</tr>
<tr class="odd">
<td colspan="3">Owner’s Name:</td>
<td colspan="11"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Vehicle Make:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Style:</td>
<td colspan="3"></td>
<td colspan="2">Year:</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3">Vehicle Number:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Status:</td>
<td colspan="3"></td>
<td colspan="2">Code:</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3">Doors Locked:</td>
<td colspan="2"></td>
<td colspan="2">Vehicle Value:</td>
<td colspan="3"></td>
<td colspan="2">Other:</td>
<td colspan="2"></td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| # NARRATIVE                                                           |
+-----------------------------------------------------------------------+
| *Ms. Johnson reports that two cars just had a head-on collision on    |
| Main St. in front of the store where she works. She thinks it is not  |
| too serious as the cars were traveling slowly, but she is not sure.   |
| Cruiser and ambulance dispatched.*                                    |
+-----------------------------------------------------------------------+

Reporting Officer: [*Off. Kerry, M.*]{.underline}

Supervising Officer: [*Off, Henry, J.K.*]{.underline}

Reviewing Officer: [*Det. Stills*]{.underline}