AGENCY INFO

Agency Name

PD

Arrest Date

Arrest Time

Case Number

Taken

 

Arrest Tract

Residence Tract

Arrest Number

ARESTEE INFO

Name (Last, First, Middle)

,

D.O.B.

Age

Race

Sex

Place of Birth

Current Address

Apt.

Phone

Occupation

Also Known As (Alias Names)

 

Hgt

Wgt

Hair

Eyes

Scars, Marks, Tattoos

 

Social Security #

OLN and State

Misc. # and Type

Nearest Relative Name

 

Address

Phone

 

ARREST INFO

If Armed, Type of Weapon

N/A

Type of Arrest

Place of Arrest

Charge #1

Type

Counts

IBR Code

Warrent/Summons #

Statute #

Warr. Date

Charge #2

Type

Counts

IBR Code

Warrent/Summons #

Statute #

Warr. Date

Charge #3

Type

Counts

IBR Code

Warrent/Summons #

Statute #

Warr. Date

VEHICLE INFO

VYR

2001

Make

Model

Style

Color

 

Plate #/State/Plate Year

VIN

Vehicle

 

CONFINED BOND

Date/Time Confined

 

Place Confined

Committing Magistrate

Type Bond

 

Bond Amount

Trial Date / Time

Court of / City

Arresting Officer Name/ID #/Bureau

 

Assisting Officer Name/ID #/Bureau

 

Released By (Name/Department/ID#)

Date/Time Released

  CODES  

1 = None

2 = Burned

3 = Counterfeit/Forged

4 = None

5 = None

6 = None

7 = None

8 = None

DRUGS AT ARREST

Code

Status

Quantity

Suspected Type

Up to 3 Types of Activity for Each

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NARRATIVE

 
 
 

 
 
 

STATUS

Arresting Officer Signature/ID #/Bureau

 

Case Status

 

Arestee Signature