ALABAMA UNIFORM INCIDENT/OFFENSE REPORT

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01 Tenninal 02 Bank 03 Bar
04 Church

II offense occurred at vi~m's residence, then only the approximate location should be listed in this (For example, a block number should be entered.) II the offense occurred elsewhere, then the address should be ~sted here.

Jf Clear 2 Cloudy 3 Rain

4 Fog

5 Snow 6 Hail 7 Unknown

05 Commercial
06 Construction

09 10 11 12 13

Drug Store FieldlWoods GovtIPublic Building Supermarket

Highway/Street 14 HoteUMotel

21 Restaurant 22 SchooVColiege
23 Service/Gas Station

07 Conv Store 08 Dept Store VI~m

Type

15 JalllPrlson 18 LakelWatelWay

24 Specialty Store 25 OtheriUnknown

R Religious S Society Org

I Individual B Business

,r Govemment

F Financial (Bank)

_..
01 Aircraft 02 Alcohol 03 Autos
04 Bicycles

07 08 09 10 11 12 13

Computer Consumables Credit Card Drugs Drug Equip Fann Equip Firearms

16 17 18 19 20 21

Household Jewelry Livestock Merchandise Money Negotiable

Goods

Instrument Instru

22 Non-negotiable

27 28 29 30 31

Recordings RVs Structure - Single Occupancy Structure - Other Dwelling Structure - Other Commercial Dwelling

34 ~ura...Stolilllll 35~u~ 36 T 001$ - Power/Hand

37 Trucks

38 Vehicle Parts/Accessories 39 Watercra!! 77 Other

05 Buses 06 Clothes

14 Gambling Equipment 15 Construction

23 Office Equipment 24 Other Motor Vehicle

[] Abandoned

1 Pending 77 Case Disposition Officer A Suspect/Offender Dead B Prosecutlon Declined! Other Prosecution C Extradition Denied Victim Relused to Cooperate E Juvenile (No Custody) F Death 01 Victim

10 Number

f-------------------1

1 2 3 4 5

Cleared by Arrest (Juvenile) Cleared by Arrest (Aduk) Unlounded Exceplional Clearance Administratively Cleared

OffIcer 10 Number

Incident/Offense

D CheckW
Mu~iple

100 Other Phone

D Handgun

D Rifle

D Shotgun

N None B Broken Bones

T Loss ofTeeth U Unconscious Treatment

tor

Rape?

I hereby affirm that I have read this report and that all the information given by me is correct to the best ot my knowledge. I will assume full responsibility for notifying the agency if any stolen property or missing person herein reported is returned.