HOUSE OVERSIGHT 018963 Date:' 7/13/06 Time: 9:27:55 PALM BEACH POLICE DEPARTMENT Incident Report Page: 10 Program: CMS301L Case No..... Street Number • 1-05-000368 (Continued) City ...... Birth Date/Age : 0/00/0000 0 Employer? . . Occupation FAMILY THERAPIST Oper Lic No. . Home Phone No. : Sex ...... Weight ..... Other Phone Nbr: 561/000-0000 Female 0 561/000-0000 Race ...... Height ..... Person Type . • • : White 0 OTHER PERSON Case Number Employer Name : Address . City/State/Zip : Phone Number ********* OTHE Case Number Street Number City ...... Bixth Date/Age : Occupation . . Home Phone No. Sex ...... ?eight . . Dther Phone Nbr: ***EMPLOYER INFORMATION*** 1-05-000368 PBC DIVISON OF YOUTH AFFAIRS 4200 N AUSTRALIAN AV WEST PALM BEACH, FL 33407 561/840-4540 PER 0 0 INFORMATION - *g********* Last Name Employer? . Oper Lic No. Race ......- White Height .....• 0 Person Type : OTHER PERSON ***EMPLOYER INFORMATION*** 2ase Number . : 1-05-000368 Em loyer Name kddress . . . : 2ity/State/Zip : ?hone Number e******** OTHER PERSO N :ase Number . : 1-05-000368 La.t Name . ;treet Number ity ...... lirth Date/Age : 0/00/0000 0 )coapation . . Tome Phone No. ;ex ...... 'eight )ther Phone Nbr: .....• .******** 0 THER PERSON !ase Number . : 1-05-000368 Itreet Number : aty ...... arth Date/Age : Iccupation . : brae Phone No. : ex b6 b7C INFORMAT • 0 7 ********* Employer? . Oper Lic No. Race ......• White Height ..... 0 Person Type : OTHER PERSON b6 b7C INFORMATION - # 8 ********* Last Name . 0/00/0000 0 Employer? . Oper Lic No. Race ...... Height . . . : 0