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EFTA01305903

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QLM BEACJOLICE DEPARTMO PROPERTY RECEIPT CONTRIBUTOR'S COPY POPO Form 052 0 PROPERTY CI FOUND 0 DECEASED (Probated) 0 PERSONAL 0 CONFISCATED CI DESTROY - EVIDENCE U TRIAL 0 LABORATORY 0 STOLEWRECOVERED BOTHER INCIDENT/CITATION NUMBER lt\ r-a- '' f • C;••, DATEMSIE RECOVERED PROPERTY NUMBER pan MHO BIN NUMBER (Ian Blenle AIDRES;WI:IERE PROPERTY IMPOUNDED 1 I . -. 1 DOI .1 - .. i . Ice t C: \ :„..) PE:: Ft __,Th 1, 1 ii-\ 0 1--i t_, i' 1: } DISCOVERED BY/ D.O.B. ' 7 t i - ; .• t i - I ADDRESS los City ZP PHONE NUMBER OWNER'S NAME / D.O.B. ADDRESS Street C. Z P )1. , i i SUSPECTS NAME / DOB. ADDRESS Street City Dp PHONE NUMBER ADDTNL. SUSPECT I D.O.B. ADDRESS Sane ay 4, PHONE NUMBER SPECIAL INSTRUCTIONS FOUND PROPERTY CLAIM 0 90 DAYS NOT CLAIM U ITEMS QUANTITY VALUE DESCRIPTION I I TA Pi; b it ..Aitirl etIrk:.-1— ;n r • kl ( : \ r $1. ••, T' f • -I— ,.. 1; TOTAL PACKAGE WEIGHT I bleby acknowledge that the above list represents all property taken kill IMAM that I have received a copy of this receipt. I hereby acknowledge by me In the official I / ,..k \ V_ _kJ that performance the above list represents all properly impounded of my duty as a police officer. • 1 H SIGNATURE DATE SIGNATURE IDS UNIT RECEIVED BY REASON DATE/TIME RECEIVED , / t le•—•-. , . -, L.... / ' 1 ( f 7 • G tr - . ROAN 0.IA N111/11/1 • ' EFTA 00195867 EFTA01305903

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