OFFENSE-INCIDENT REPORT N 1 M Holmes Beach...

30
Holmes Beach Police Department FL0410400 26 00 0859 1 1 1 STATE 2018 NE FLORIDIAN CIR. 34266 ARCADIA LABORER NONE SHIRT / JEANS NONE 5-07 175 0859 0859 0920 0859 0859 32 20170707 MEXICO OF FLORIDA DRIVERS LICENSE Thu Thu Thu 1 V 5 RANGEL FRIAS JUAN ANTONIO 1 2 A M W BRO BLK FL M S LT MED M FL 03 1 9000 4 322 C DRIVERS LIC ___-____ ___ ___-__-____ ___ ___-____ ___-____ ___ ___ ___-____ ___-____ ___ ___ ___-____ 34217 W80 ROADWAY PALM DRIVE HOLMES BEACH 6700 0 0 I RAN TAG (EEFR40)THAT WAS AFFIXED TO LINCOLN. THE FCIC/NCIC QUERY STATED THE REGISTERED OWNER DID NOT HAVE A VALID LICENSE. I RAN HIS NAME THROUGH IN-CAR FCIC/NCIC AND CONFIRMED IT. I INITIATED A TRAFFIC STOP ON VEHICLE AND DRIVER WAS THE REGISTERED OWNER. I WAS GIVEN A MEXICAN CONSULAR CARD AND EXPIRED INSURANCE. I ISSUED DRIVER A SUMMONS TO APPEAR FOR NO LICENSE AND A CIVIL CITATION FOR NO PROOF OF INSURANCE. DRIVER SIGNED OUR COPY OF THE SUMMONS. PATROL 1 1 JASON HIGGINS SGT.K.POWERS 320 331 1 EVENT DATA NARRATIVE SUSPECT 00. N/A 01. Gunshot 02. Stabbed CODES ADM A-Attempted C-Committed A-Attempted C-Committed Area T y p e o f W e a p o n 01. Residence Single 02. Apartment/Condo 03. Residence-Other 04. Hotel/Motel Time (mil) Time Dispatched (mil) Primary Offense Description 21. Employer 22. Landlord/Tenant 23. Acquaintance 99. Other Known 5. Ordinance 9. Other Zone ) Agency Report Number 3. Misdemeanor 4. Traffic Misdemeanor OFF/INC #2 OFF/INC #1 Business Name/Area Identifier District NCIC/UCR Code 2. No L o c a t i o n T y p e V / W C o d e # Victims 00. N/A 01. Handgun 05. Knife/Cutting Instrument 06. Blunt Object 07. Hands/Fist/Feet 08. Poison 09. Explosives 10. Fire/Incendiary 11. Threat/Intimidation 12. Simulated Weapon V - Victim W - Witness C - Reporting Person O - Other R a c e N - N/A M - Male F - Female U - Unknown R e s i d e n c e T y p e 0. N/A 1. City 2. County E x t e n t o f I n j u r y R e s i d e n c e S t a t u s 03. Laceration 04. Unconscious 05. Poss. Broken Bones 06. Poss. Internal Injury V i c t i m R e l a t i o n s h i p T o O f f e n d e r 07. Loss of Teeth 08. Burns 09. Abrasions/Bruises 99. Other 06. Parent 07. Brother/Sister 08. Child 09. Step-Parent 10. Step-Child 11. In-Law 12. Other Family 13. Student V/W Code # Name (Last, First, Middle or Business) Residence Phone Business Phone Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge? Synopsis of Involvement Residence Phone Business Phone Juvenile Occupation Sex Date of Birth Height Weight Eye Color Hair Length Hair Style Nickname/Street Name Place of Birth Social Security Number SCIC/NCIC Employer/School Teeth Speech/Voice Special Identifiers Original Day Reported Date Time (mil) Time Arrived (mil) Time Completed (mil) 1. Felony 2. Traffic Felony To Time (mil) ( - Type 30. Other Mobile 99. Other 15. Industrial/Mfg. 16. Storage 17. Gov't/Public Bldg. 18. School/University 19. Jail/Prison 20. Religious Bldg. 21. Airport 22. Bus/Rail Terminal 23. Construction Site 24. Other Structure 25. Parking Lot/Garage 26. Highway/Roadway 27. Park/Woodlands/Field 28. Lake/Waterway 29. Motor Vehicle 10. Dept/Discount Store 11. Specialty Store 12. Drug Store/Hospital 13. Bank/Financial Inst. 14. Commercial/Office Bldg. S u s p e c t C o d e Incident Location (Street Number, Street, Apt,) Scars/Marks/Tatoos (Location/Describe) 0. N/A 1. Occupied E-Escapee Z-Other From Date of Supplement - ( 17. Friend 18. Neighbor 19. Sitter/Day Care 20. Employee V/W Code # Name (Last, First, Middle or Business) Residence Phone Business Phone Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge? Synopsis of Involvement V. Type O F F / I N C I n d i c a t o r OBTS Number (Arrested) Other I.D. Number Immigration and Naturalization Number I n c i d e n t T y p e Incident: Day Date 2. Unoccupied 3. Abandoned 05. Convenience Store 06. Gas Station 07. Liquor Sales 08. Bar/Nightclub 09. Supermarket Date Day 0. N/A 1. Yes F o r c e d E n t r y O c c u p a n c y Statute Violation Number - Chapter, Section, Sub Description Type Hair Color Race Facial Hair Build Complexion Driver's License Number/State Address Code Maiden Name Name (Last, First, Middle) Extent of Injury Res. Status Res. Type Zip State City Extent of Injury Res. Status Res. Type Zip State City 13. Drugs 88. Unknown 99. Other Grid V i c t i m T y p e 0. N/A 1. Juvenile 2. L.E. Officer 3. Adult 4. Business 5. Government 6. Church 9. Other S e x I - American Indian O - Oriental/Asian U - Unknown N - N/A W - White B - Black 3. Florida 4. Out-of-State 0. N/A 1. Full Year 2. Part Year 3. Non-Resident 0. None 1. Minor 2. Serious 3. Fatal 14. Teacher 15. Child of Boy/Girl Friend 16. Boy/Girl Friend 03. Spouse 04. Ex-Spouse 05. Co-Habitant 00. N/A 01. Undetermined 02. Stranger I n j u r y T y p e Clothing (Describe) Zip State City 02. Rifle 03. Shotgun 04. Firearm Susp. # VICTIM / WITNESS VICTIM / WITNESS # Prem. Ent. S-Suspect A-Arrestee Dom. Violence Dom. Violence Zip City # OFF/INC. # Offenders # Veh. Stolen 1.#1 2.#2 3.Both ) Age Date of Birth Age Date of Birth Age Address (Street, Apt. Number) Other Contact Info. (Time Available, Interpreter, etc.) Address (Street, Apt. Number) Other Contact Info. (Time Available, Interpreter, etc.) Last Known Address (Street, Apt. Number) V. Type O F F / I N C I n d i c a t o r If V/W Code is V, W or C Fill in this Line 1.#1 2.#2 3.Both O F F / I N C I n d i c a t o r If V/W Code is V, W or C Fill in this Line 1.#1 2.#2 3.Both Person/Unit Notified Case Status Time Routed To Referred Related Report Number(s) Unit of Page Number Arrested C l e a r a n c e T y p e E x c e p t i o n T y p e 2. Arrest on Primary Offense Secondary Offense Without Prosecution 3. Death of Offender 4. V / W Refused to Cooperate 3.Unfounded Page Date 5. Prosecution Declined 6. Juvenile/No Custody 1.Extradition Declined 1.Arrest 2.Exceptional Jail Number OBTS Number Date Cleared By Assigned To ADMINISTRATIVE A-Adult J-Juvenile Date Name of Officer Reporting Officer Reviewing (If Applicable) I.D. Number I.D. Number/Locator Code 1. Original 2. Supplement Juvenile in Report Juvenile Warn/Dismiss 1 __/__/____ 08/24/2017 08/24/2017 08/24/2017 __/__/____ 08/24/2017 __/__/____ 11/10/1984 Signature of Officer Reporting Signature of Officer Reviewing Yes No Yes No 1 2 N OFFENSE-INCIDENT REPORT Gang Related C O P Y

Transcript of OFFENSE-INCIDENT REPORT N 1 M Holmes Beach...

Page 1: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Holmes Beach Police Department

FL0410400

26

00

0859

1 1 1

STATE

2018 NE FLORIDIAN CIR. 34266ARCADIA

LABORER

NONE

SHIRT / JEANS NONE

5-07 175

0859 0859 0920

0859 0859

32

20170707

MEXICO

OF FLORIDA

DRIVERS LICENSE

Thu Thu

Thu

1V 5

RANGEL FRIAS JUAN ANTONIO1 2A

MW BRO BLK

FL

M S

LT MED M

FL

03 1 90004 322CDRIVERS LIC

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

34217 W80

ROADWAY

PALM DRIVE HOLMES BEACH6700

0 0

I RAN TAG (EEFR40)THAT WAS AFFIXED TO LINCOLN. THE FCIC/NCIC QUERY STATED THE REGISTERED OWNERDID NOT HAVE A VALID LICENSE. I RAN HIS NAME THROUGH IN-CAR FCIC/NCIC AND CONFIRMED IT. I INITIATED ATRAFFIC STOP ON VEHICLE AND DRIVER WAS THE REGISTERED OWNER. I WAS GIVEN A MEXICAN CONSULAR CARD ANDEXPIRED INSURANCE. I ISSUED DRIVER A SUMMONS TO APPEAR FOR NO LICENSE AND A CIVIL CITATION FOR NOPROOF OF INSURANCE. DRIVER SIGNED OUR COPY OF THE SUMMONS.

PATROL

11

JASON HIGGINS

SGT.K.POWERS 320

331

1

EV

EN

TD

AT

AN

AR

RA

TIV

ES

US

PE

CT

00. N/A01. Gunshot02. Stabbed

CO

DE

SA

DM

A-Attempted

C-Committed

A-Attempted

C-Committed

Area

Type of Weapon

01. Residence Single

02. Apartment/Condo

03. Residence-Other

04. Hotel/Motel

Time (mil)

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance

9. Other

Zone

)

Agency Report Number

3. Misdemeanor

4. Traffic Misdemeanor

OFF/INC

# 2

OFF/INC

# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims

00. N/A01. Handgun

05. Knife/CuttingInstrument

06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - Other

Race

N - N/AM - MaleF - FemaleU - Unknown

Residence Type

0. N/A1. City2. County

Extent of InjuryResidence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

Residence Phone

Business Phone

Juvenile

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony

2. Traffic Felony To

Time (mil)

(-

Type

30. Other Mobile

99. Other

15. Industrial/Mfg.

16. Storage

17. Gov't/Public Bldg.

18. School/University

19. Jail/Prison

20. Religious Bldg.

21. Airport

22. Bus/Rail Terminal

23. Construction Site

24. Other Structure

25. Parking Lot/Garage

26. Highway/Roadway

27. Park/Woodlands/Field

28. Lake/Waterway

29. Motor Vehicle

10. Dept/Discount Store

11. Specialty Store

12. Drug Store/Hospital

13. Bank/Financial Inst.

14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

0. N/A

1. Occupied

E-EscapeeZ-Other

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied

3. Abandoned

05. Convenience Store

06. Gas Station

07. Liquor Sales

08. Bar/Nightclub

09. Supermarket

DateDay

0. N/A

1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

13. Drugs88. Unknown99. Other

Grid

Victim Type

0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex

I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl

Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

Susp. #

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

# Prem. Ent.

S-SuspectA-Arrestee

Dom. Violence

Dom. Violence

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

Age

Date of Birth Age

Date of Birth Age

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

V. TypeOFF/INC Indicator

If V/W Code isV, W or C

Fill in this Line

1.#12.#2

3.Both

OFF/INC Indicator

If V/W Code isV, W or C

Fill in this Line

1.#12.#2

3.Both

Person/Unit Notified

Case Status

Time

Routed To Referred

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

1. Original2. Supplement

Juvenilein Report

JuvenileWarn/Dismiss

1

__/__/____

08/24/2017

08/24/2017 08/24/2017

__/__/____

08/24/2017

__/__/____

11/10/1984

Signature of Officer Reporting

Signature of Officer Reviewing

Yes No

YYeess NNoo

12 NOFFENSE-INCIDENT REPORTGangRelated

C O P

Y

Page 2: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

2. No

FL0410400

26

00

2050

2 1 1 0 0

VICKERS

5610 SOLITARE PALM WAY 33572APOLLO BEACH

UNEMPLOYED

V262165853790

606 250

Holmes Beach Police Department

2050 2050 2300

2050 2300

31

20170709

FLORIDA

DAVID EARL

DWLSR

1

Thu

Thu Thu

1 STATE OF FLORIDA

2 NN

MW

V 5

2A

BLU BLD

0 0 0 00 0000

FL

LT MUS

FL

BORES

SGT.COPEMAN 307

34 2c 9000

13 6b 350ACMARIJUANA-POSSE

322

893

CDRIVERS LIC

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

S X

34217GULF DR HOLMES BEACH3101

0 0

3

2

3

326

3

SHORTS AND TEE SHIRT BODY TATTOOS

N2 1

00. N/A

01. Gunshot

02. Stabbed

OFF/INC Indicator

EV

EN

TD

AT

AN

AR

RA

TIV

ES

US

PE

CT

CO

DE

SA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer

22. Landlord/Tenant

23. Acquaintance

99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

Location Type

V/W Code

# Victims

00. N/A01. Handgun

05. Knife/CuttingInstrument

06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - Victim

W - Witness

C - Reporting Person

O - Other

Race

N - N/A

M - Male

F - Female

U - Unknown

Residence Type

0. N/A

1. City

2. County

Extent of InjuryResidence Status

03. Laceration

04. Unconscious

05. Poss. Broken Bones

06. Poss. Internal Injury

Victim Relationship To Offender07. Loss of Teeth

08. Burns

09. Abrasions/Bruises

99. Other

06. Parent

07. Brother/Sister

08. Child

09. Step-Parent

10. Step-Child

11. In-Law

12. Other Family

13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend

18. Neighbor

19. Sitter/Day Care

20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type0. N/A

1. Juvenile

2. L.E. Officer

3. Adult

4. Business

5. Government

6. Church

9. Other

Sex

I - American Indian

O - Oriental/Asian

U - Unknown

N - N/A

W - White

B - Black

3. Florida

4. Out-of-State

0. N/A

1. Full Year

2. Part Year

3. Non-Resident

0. None

1. Minor

2. Serious

3. Fatal

14. Teacher

15. Child of Boy/Girl

Friend

16. Boy/Girl Friend

03. Spouse

04. Ex-Spouse

05. Co-Habitant

00. N/A

01. Undetermined

02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

If V/W Code isV, W or C

Fill in this LineOFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2

3.Both

Date of Birth Age

Date of Birth Age

If V/W Code isV, W or C

Fill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Age

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type2. Arrest on Primary Offense

Secondary Offense Without Prosecution3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

08/24/2017

08/24/2017 08/24/2017

__/__/____

08/25/2017

__/__/____

__/__/____

USA Rev. 01/23/2003

10/19/1985

Signature of Officer Reviewing

Signature of Officer Reporting

SEE NARRATIVE PAGE..

Yes No

YYeess NNoo

C O P

Y

Page 3: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Holmes Beach Police Department 20170709

N 1

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

___-__-____

___-_______

___ ___-____

326

SGT.COPEMAN

BORES

307

DWLSR STATE OF FLORIDA

CO

DE

SA

DM

Juvenilein Report:

Date of Supplement

Primary Offense Description

Victim Type Race

Victim Relationship To Offender

Agency Report Number

Residence Type Residence Status4. Business5. Government6. Church9. Other

SexN-N/AM-MaleF-FemaleU-Unknown

0. N/A1. City2. County

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

00. N/A01. Undetermined02. Stranger

03. Spouse04. Ex-Spouse05. Co-Habitant

06. Parent07. Brother/Sister08. Child09. Step-Parent

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

PERSON(S) REPORT

Injury Type

00. N/A01. Gunshot02. Stabbed

Original Date

1. Original2. Supplement:

0. N/A1. Juvenile2. L.E. Officer3. Adult

N-N/AW-WhiteB-Black

I-American IndianO-Oriental/AsianU-Unknown

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

10. Step-Child11. In-Law12. Other Family13. Student

Victim #1 Name (Last, First, Middle)

V/W Code

V - VictimW - WitnessC - Reporting Person

O - Other

Will Victim prefer charge?

Will Victim prefer charge?

Extent of Injury

SU

SP

EC

TO

RM

ISS

ING

PE

RS

ON

S

If V/W Code isV, W or C

Fill in this LineOFF/INC Indicator

OFF/INC Indicator V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Relationship Ethnicity

Synopsis of Involvement

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code isV, W or C

Fill in this Line

Address (Street, Apt. Number)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Other Contact Info. (Time Available, Interpreter, etc.)

SU

SP

EC

TO

RM

ISS

ING

PE

RS

ON

S

Hair Color

Suspect Code Code

Maiden Name

Occupation

Driver's License State/Number

Employer/School

Immigration and Naturalization Number Other ID. Number

Address

Place of Birth Residence Phone

Business Phone

Social Security Number

OBTS Number

Date of Birth or Age Height

Complexion Facial Hair Teeth Speech/Voice Special Identifiers

Eye Color Hair Length Hair Style

Name (Last, First, Middle)

Clothing (Describe)

Last Known Address (Street, Apt. Number)

OFF/INC Indicator

1.#12.#2

Sex

Nickname/Street Name

SCIC/NCIC

WeightRace

Juvenile

Build

3.Both

City

Maiden Name

Occupation

Driver's License State/Number

Employer/School

Immigration and Naturalization Number Other ID. Number

Address

Place of Birth Residence Phone

Business Phone

Social Security Number

OBTS Number

Date of Birth Height

Complexion Facial Hair Teeth Speech/Voice Special Identifiers

Eye Color Hair Length Hair Style

State Zip

Clothing (Describe)

Last Known Address (Street, Apt. Number)

Sex

Nickname/Street Name

SCIC/NCIC

Hair ColorWeightRace

Build

Code Name (Last, First, Middle)OFF/INC Indicator

1.#12.#2

Juvenile

3.Both

Susp. #

E-EscapeeM-Missing

Suspect Code

S-SuspectA-Arrestee

R-Rec. MissingZ-other

Susp. #

Age

V. Type

E-EscapeeM-Missing

S-SuspectA-Arrestee

R-Rec. MissingZ-other

Injury Type(s)

ZipStateCity

Scars/Marks/Tatoos (Location/Describe)

Scars/Marks/Tatoos (Location/Describe)

MIS

SIN

GP

ER

SO

N/

RU

NA

WA

Y 7. VoluntaryAdult

8. Unknown

1. Yes2. No8. Unknown

Incident Type

1. Runaway2. Parental3. Involuntary

Foul Play Suspected ?

1. Yes2. No

Missing Before ?

1. Yes2. No8. Unknown

1. Yes2. No8. Unknown

1. Yes2. No8. Unknown

MCIC Form Provided ?

4. Disabled5. Endangered6. Disaster Victim

Fingerprints Available? Dental Record Available

1. Yes2. No

Photo Available?

Date Last Seen Time Last Seen Accompanied By

Property Carried

Probable Destination

Medication Required/Type

ID. Type/Number

Recovery Information7. Deceased9. Other

Doctor/Dentist (Name, Phone Number)

Transportation Mode

Location Last Seen (Address, City, St.)

5. Law Enforcement Custody6. Returned to Parent

3. Hospitalized4. HRS Custody

2. Located-Not Returned

0. N/A1. Voluntary

Name/Address

ID. Type/Number

Mental/Physical Condition

AD

MIN

IST

RA

TIV

E

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reporting

__/__/____

08/25/2017

__/__/____

08/24/2017

USA Rev. 01/23/2003

__/__/____

Signature of Officer Reviewing

YYeess NNoo

YYeess NNoo

C O P

Y

Page 4: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Type

Type

Type

Code Person

Code Person

Code Person

Code Person

Code Person

Holmes Beach Police Department20170709

1

BURNT MARIJUANA BLUNT

1 MARIJUANA1

1

CELL PHONE

2 CELL PHONE1

9

A 0

D

Z

8

8

0.00

0.00

326

SGT.COPEMAN

BORES

307

1

DWLSR STATE OF FLORIDA

A

TH

EF

TA

DM

A. Auto Accessory/PartsB. BicycleC. Camera/Photo EquipmentD. Drug

T. TV/Video/VCRU. Currency/NegotiableV. Credit Card/Non-NegotiableW. Boat MotorX. Structure

Property TypeO. Office EquipmentP. Art/CollectionQ. Computer EquipmentR. Radio/StereoS. Sports Equipment

E. Equipment/Tool.F. Food/Liquor/ConsumableG. GunH. Household Appliance/GoodsI. Plant/Citrus

J. Jewelry/Precious MetalK. Clothing/FurL. LivestockM. Musical InstrumentN. Construction Machinery

Date of Supplement

Original Date Reported Primary Offense Description Victim #1 Name (Last, First, Middle)

Agency Report Number

1. Original2. SupplementPROPERTY REPORT

Y. Farm EquipmentZ. Miscellaneous

PR

OP

.D

ET

AIL

/N

AR

R.

CO

DE

S

09. From Vehicle10. Extortion

Theft Type Codes

04. Pocket Picking05. Purse Snatching

06. Embezzlement07. From Coin Oper. Machine

08. From PublicAccess Building

11. By Computer12. Fraud

99. Other00. N/A01. Burglary

02. Robbery03. Shoplifting

Theft Type

A - ArresteeO - Other

1. Stolen2. Recovered

V - VictimS - Suspect

5. Lost6. Found

Person Codes Status Codes

3. Stolen and Recovered4. Recovered for Other Jurisdiction

2. Criminal Mischief3. During other Offense

7. Safekeeping8. Evidence/Seized

9. Other9. Other

Damage Codes

0. N/A1. Arson

PR

OP

ER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PropertyStolen

PropertyRecovered

Change in PropertyStolen Value

Change in PropertyRecovered Value

Activity Type Unit

Activity Description Quantity Unit

P. PossessS. SellB. BuyT. Traffic

R. SmuggleD. DeliverE. UseK. Dispense/Distribute

M. Manufacture/Produce/CultivateZ. Other

A. AmphetamineB. BarbiturateC. CocaineE. Heroin

H. HallucinogenM. MarijuanaO. Opium/DerivativeP. Paraphernalia/Equipment

S. SyntheticU. UnknownZ. Other

1. Gram2. Milligram3. Kilogram4. Ounce

5. Pound6. Ton7. Liter8. Milliliter

Estimated Street Value

TO

TA

LS

CO

DE

SD

RU

GS

PR

OP

ER

TY

Serial Number

NameItem # Status Damage Property Type Quantity BrandModel Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Activity Description Quantity Unit Estimated Street Value

Activity Description Quantity Unit Estimated Street Value

AD

MIN

IST

RA

TIV

E

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reviewing

Signature of Officer Reporting

9. Dose Unit/Item

__/__/____

08/24/2017

__/__/____

__/__/____

__/__/____

__/__/____

__/__/____

08/25/2017

__/__/____

USA Rev. 01/23/2003

C O P

Y

Page 5: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

AD

M

1100.. OOtthheerr -- SSppeecc..66.. TTrraannss..

77.. EEnnggiinnee PPaarrttss

1. Key

11.. KKeeyy

3. Hot Wire

6. Trans.

7. Engine Parts

8. Major Body Parts

VE

HIC

LE

/V

ES

SE

L1. Original2. Supplement

Date of Supplement

Reg. State

Date Recovered

LengthVessel Name

StyleModelStatusPerson #

1. Local / Local

2. Local / Other

3. Other / Local

Tag Type

Primary Offense Description Victim #1 Name (Last, First, Middle)

Person Code Status Code Damage Code Type Recovery Location Recovery Code

Stolen / Recovered

Holmes Beach Police Department

1. Stolen2. Recovered3. Stolen and

Recovered4. Suspicious

5. Impounded6. Abandoned7. Fail Return8. Seized9. Other

0. N / A1. Arson2. Criminal Mischief3. During Other Offense

1. Auto2. Truck / Van3. Motorcycle4. Camper / RV5. Bus

6. Trailer7. Boat8. Aircraft9. Other

VEHICLE REPORT

Original Date Reported

Agency Report Number

Description (Identifying Characteristics, Noticeable Damage, Interior Color, etc)

Tag Reg./Doc. # Reg. Year Decal Number

VIN/Hull/FAA Estimated Value

Propulsion

Insurance Company Lien HolderCondition

Hull Material Boat Type

Recovery Address/Geographic Indicator

Recovery Loc. Recovery Code Original Reporting Agency Report Number Reason/Authority

SCIC/NCIC Location of Original Theft

Value Recovered

1. Window Closed

708PMX

2G4WC582461289641

2. Locked 3. Keys in Ignition

WHITE

Color (Top/Bottom)

Towed By

Components Stripped

0. N/A 5. Interior 9. Tag/Decal Stolen

10. Other - Spec.0. N/A 8. Unk.2. Tow Truck 4. Steering

5. Ignition 1. VIN Plt.

4. Battery

Person Code Damage Type Year Make

2006 BUICK 4DR 4DR

Storage Location

V- VictimS- SuspectA- ArresteeO- Other

5. Park / Playground6. Shopping Mall7. Woods8. Water9. Other

1. Family Residence2. Apt. Complex3. Housing Project4. Commercial /

Industrial

4. Stripped / TheftFrom

9. Other

CO

DE

SV

EH

ICL

E/V

ES

SE

LV

EH

ICL

EIN

V./N

AR

RA

TIV

E

Person Code Person # Status Damage StyleModelType Year Make

Reg. State Tag TypeTag Reg./Doc. # Reg. Year Decal Number

VIN/Hull/FAA Estimated Value

Insurance Company Lien HolderCondition

1. Window Closed1. Window Closed 2. Locked2. Locked 3. Keys in Ignition3. Keys in Ignition

Description (Identifying Characteristics, Noticeable Damage, Interior Color, etc)Color (Top/Bottom)

LengthVessel Name PropulsionHull Material Boat Type

Date RecoveredRecovery Address/Geographic Indicator Value Recovered

Recovery Loc. Recovery Code Original Reporting Agency Report Number Reason/Authority

Methodof Theft

00.. NN//AA 88.. UUnnkk..22.. TTooww TTrruucckk

33.. HHoott WWiirree

44.. SStteeeerriinngg

55.. IIggnniittiioonn

Components Stripped

00.. NN//AA 55.. IInntteerriioorr

88.. MMaajjoorr BBooddyy PPaarrttss

99.. TTaagg//DDeeccaall SSttoolleenn11.. VVIINN PPlltt..

44.. BBaatttteerryy

Location of Original TheftTowed By Storage Location SCIC/NCIC

Vehicle #

HoldY - YesN - No

HoldY - YesN - No

Vehicle #

Methodof Theft

2. Tires/Wheels

3. Radio/CB

22.. TTiirreess//WWhheeeellss

33.. RRaaddiioo//CCBB

FL

Case Status

Routed To Referred To

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

BORES

SGT.COPEMAN 307

326

Arrest Number

20170709

DWLSR STATE OF FLORIDA

11 09A 1

1

2018

__/__/____

__/__/____

08/25/2017

__/__/____

__/__/____

USA Rev. 01/21/2003

__/__/____

08/24/2017

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Page 6: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

1. Offense

2. Arrest

Juvenile

Warn/Dismiss

1. Original

2. Supplement

AD

M

Holmes Beach Police Department

DWLSR

FL0410400 20170709

2 1

BORES

SGT.COPEMAN 307

326

ON 08/24/2017 AT 20:50 HRS I WAS ON PATROL SITTING IN THE PARKIG LOT OF 3101 GULF DR. (MIKE NORMANS

REALITY) FACING THE INTERSECTIN OF GULF DR. AND EAST BAY DR. WHILE SITTING IN THE PARKING LOT I

OBSERVED A WHITE 4DR BUICKBEARING FLORIDA REGISTRATION (FL,708PMX) APPROACH THE INTERSECTION AND TURN

LEFT ONTO GULF DR. I HAD PRIOR KNOWLEDGE THAT THE WHITE BUICK WAS DRIVEN BY THE DEFENDANT WHO'S

DRIVER'S LICENSE HAS BEEN REVOKED ON 01/2007. I OBSERVED THE DEFENDANT DRIVING THE VEHICLE AS IT

TURNED LEFT ONTO GULF DR.I PULLED ONTO GULF DR TO GET BEHIND THE WHITE BUICK AS IT CONTINUED TO DRIVE

NORTH. I ACTIVATED MY EMERGENCY WARNING LIGHTS AND HE VEHICLE HAD A SLOW RESPONSE UNTIL FINALLY

STOPPING IN THE 3700 BLK OF GULF DR.

I APPROACHED THE VEHICLE ON THE DRIVER'S SIDE AND MADE CONTACT WITH THE DRIVER. I CONFIRMED THAT THE

DRIVER WAS DAVID E. VICKERS (V262165853790) THROUGH D.A.V.I.D. AND HBPD DISPATCH. AT THAT TIME I ASKED

MR. VICKERS TO STEP OUT OF THE VEHICLE AND PLACED HIM INTO CUSTODY AND PUT IN THE REAR OF MY PATROL

VEHICLE. DURING THE INVENTORY OF THE VEHICLE I LOCATED A BURNT MARIJUANA BLUNT CIGAR ON THE CENTER

CONSOLE. THE MARIJUANA CIGAR HAD THE TOTAL WEIGHT OF .1 GRAMS. MR. VICKERS ALSO HAD EIGHT PRIOR

CONVICTIONS OF DWLS/R AND WAS REVOKED ON 01/2007. I LATER TRANSPORTED MR. VICKERS TO MCSO JAIL.

THE FOLLOWING CITATIONS WERE ALSO ISSUED: A2H5XUE (DWLS/R, 3RD OR SUBSEQUENT).

NA

RR

AT

IVE

Original Date Reported

NARRATIVE CONTINUATION

Case Reference

Date of Supplement Agency ORI Number Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

08/24/2017

08/25/2017

__/__/____

__/__/____

USA Rev. 01/23/2003

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

Page 7: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

504FW 2511/19/1991 150 BRO BLK L S

FL0410400

27

00

0254

01 01 02 00 00

GUTIERREZ

6011 FLORA TR 33572APOLLO BEACH

G362531919190

Holmes Beach Police Department

0254 0254 0330

20170710

FLORIDA

LYDIA KARINA

COV ALCOHOL

01

Thu

01 CITY OF HOLMES BEACH

5801 MARINA DRIVE HOLMES BEACH 3421

2 NN

V 5

2A

1 0 0 00 0000

FL

FL

MED MED

FL

WALKER

SGT.COPEMAN 307

6 6-3A 00000ACOV/ALCOHOL

___-_______

___-__-____

941 708-5804

___-_______

___ ___-____

___-_______

___ ___-____

34217GULF DRIVE HOLMES BEACH4000

0

5

1

312

1

COV ALCOHOL

N2 1

00. N/A

01. Gunshot

02. Stabbed

OFF/INC Indicator

EV

EN

TD

AT

AN

AR

RA

TIV

ES

US

PE

CT

CO

DE

SA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer

22. Landlord/Tenant

23. Acquaintance

99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims

00. N/A01. Handgun

05. Knife/CuttingInstrument

06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - Victim

W - Witness

C - Reporting Person

O - Other

Race

N - N/A

M - Male

F - Female

U - Unknown

Residence Type

0. N/A

1. City

2. County

Extent of InjuryResidence Status

03. Laceration

04. Unconscious

05. Poss. Broken Bones

06. Poss. Internal Injury

Victim Relationship To Offender07. Loss of Teeth

08. Burns

09. Abrasions/Bruises

99. Other

06. Parent

07. Brother/Sister

08. Child

09. Step-Parent

10. Step-Child

11. In-Law

12. Other Family

13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend

18. Neighbor

19. Sitter/Day Care

20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair Color

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type0. N/A

1. Juvenile

2. L.E. Officer

3. Adult

4. Business

5. Government

6. Church

9. Other

Sex

I - American Indian

O - Oriental/Asian

U - Unknown

N - N/A

W - White

B - Black

3. Florida

4. Out-of-State

0. N/A

1. Full Year

2. Part Year

3. Non-Resident

0. None

1. Minor

2. Serious

3. Fatal

14. Teacher

15. Child of Boy/Girl

Friend

16. Boy/Girl Friend

03. Spouse

04. Ex-Spouse

05. Co-Habitant

00. N/A

01. Undetermined

02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

If V/W Code isV, W or C

Fill in this LineOFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2

3.Both

Date of Birth Age

Date of Birth Age

If V/W Code isV, W or C

Fill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type2. Arrest on Primary Offense

Secondary Offense Without Prosecution3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____

08/24/2017

08/25/2017

__/__/____

USA Rev. 01/23/2003

Thu Thu08/24/2017 08/24/2017

Sex Date of BirthRace Age

__/__/____

Yes No

YYeess NNoo

0

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Page 8: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Holmes Beach Police Department1 1

WALKER

SGT.COPEMAN 307

312

ON 08/25/2017, AT 0253 HOURS, WHILE PATROLING 4000 GULF DRIVE, I OBSERVED A VEHICLE ILLEGALLY PARKED

IN A HANDICAPPED SPOT AFTER HOURS. USING NIGHTVISION I LOCATED TWO FEMALES HAVING RELATIONS ON THE

BEACH WHILE IN POSSESSION OF ALCOHOL. UPON SPEAKING WITH THE FEMALES (LYDIA GUTIERREZ) AND (SARAI

AGUILAR), THEY ADVISED THE ALCOHOL WAS THEIRS AND THAT THEIR VEHICLE WAS PARKED IN THE LOT. I ISSUED

EACH A CITATION FOR POSSESSION OF ALCOHOL ON THE BEACH AND ISSUED GUTIERREZ A PARKING CITATION FOR

PARKING IN A HANDICAP SPOT WITH NO PLACARD.

NA

RR

AT

IVE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense

2. Arrest

Juvenile

Warn/Dismiss

1. Original

2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

08/24/2017

08/25/2017

__/__/____

__/__/____

USA Rev. 01/23/2003

20170710FL0410400

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

Page 9: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

2. No

FL0410400

26

00

0310

1 1 1 0 0

COPELAND

1244 JORDAN PARK 33712ST PETERSBURG

DRIVER DUNKIN DONUTS

C145012943641

603 275

Holmes Beach Police Department

0310 0310 0600

0310 0600

22

20170711

FLORIDA

AUSTIN LAMAR

WARRANT

1

Fri

Fri Fri

1 STATE OF FLORIDA

2 NN

MB

V 5

2A

BRO BLK

0 0 0 00 0000

FL

MED MUS

FL

BORES

SGT.COPEMAN 307

16 2800901AWARRANT

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

S

34217MANATEE AVE HOLMES BEACH700

0 0

9

1

326

1

SHORTS AND TEE SHIRT

N2 1

00. N/A

01. Gunshot

02. Stabbed

OFF/INC Indicator

EV

EN

TD

AT

AN

AR

RA

TIV

ES

US

PE

CT

CO

DE

SA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer

22. Landlord/Tenant

23. Acquaintance

99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

Location Type

V/W Code

# Victims

00. N/A01. Handgun

05. Knife/CuttingInstrument

06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - Victim

W - Witness

C - Reporting Person

O - Other

Race

N - N/A

M - Male

F - Female

U - Unknown

Residence Type

0. N/A

1. City

2. County

Extent of InjuryResidence Status

03. Laceration

04. Unconscious

05. Poss. Broken Bones

06. Poss. Internal Injury

Victim Relationship To Offender07. Loss of Teeth

08. Burns

09. Abrasions/Bruises

99. Other

06. Parent

07. Brother/Sister

08. Child

09. Step-Parent

10. Step-Child

11. In-Law

12. Other Family

13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend

18. Neighbor

19. Sitter/Day Care

20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type0. N/A

1. Juvenile

2. L.E. Officer

3. Adult

4. Business

5. Government

6. Church

9. Other

Sex

I - American Indian

O - Oriental/Asian

U - Unknown

N - N/A

W - White

B - Black

3. Florida

4. Out-of-State

0. N/A

1. Full Year

2. Part Year

3. Non-Resident

0. None

1. Minor

2. Serious

3. Fatal

14. Teacher

15. Child of Boy/Girl

Friend

16. Boy/Girl Friend

03. Spouse

04. Ex-Spouse

05. Co-Habitant

00. N/A

01. Undetermined

02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

If V/W Code isV, W or C

Fill in this LineOFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2

3.Both

Date of Birth Age

Date of Birth Age

If V/W Code isV, W or C

Fill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Age

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type2. Arrest on Primary Offense

Secondary Offense Without Prosecution3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

08/25/2017

08/25/2017 08/25/2017

__/__/____

08/25/2017

__/__/____

__/__/____

USA Rev. 01/23/2003

10/04/1994

Signature of Officer Reviewing

Signature of Officer Reporting

SEE NARATIVE PAGE..

Yes No

YYeess NNoo

C O P

Y

Page 10: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Holmes Beach Police Department 20170711

N 1

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

___-__-____

___-_______

___ ___-____

326

SGT.COPEMAN

BORES

307

WARRANT STATE OF FLORIDA

CO

DE

SA

DM

Juvenilein Report:

Date of Supplement

Primary Offense Description

Victim Type Race

Victim Relationship To Offender

Agency Report Number

Residence Type Residence Status4. Business5. Government6. Church9. Other

SexN-N/AM-MaleF-FemaleU-Unknown

0. N/A1. City2. County

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

00. N/A01. Undetermined02. Stranger

03. Spouse04. Ex-Spouse05. Co-Habitant

06. Parent07. Brother/Sister08. Child09. Step-Parent

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

PERSON(S) REPORT

Injury Type

00. N/A01. Gunshot02. Stabbed

Original Date

1. Original2. Supplement:

0. N/A1. Juvenile2. L.E. Officer3. Adult

N-N/AW-WhiteB-Black

I-American IndianO-Oriental/AsianU-Unknown

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

10. Step-Child11. In-Law12. Other Family13. Student

Victim #1 Name (Last, First, Middle)

V/W Code

V - VictimW - WitnessC - Reporting Person

O - Other

Will Victim prefer charge?

Will Victim prefer charge?

Extent of Injury

SU

SP

EC

TO

RM

ISS

ING

PE

RS

ON

S

If V/W Code isV, W or C

Fill in this LineOFF/INC Indicator

OFF/INC Indicator V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Relationship Ethnicity

Synopsis of Involvement

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code isV, W or C

Fill in this Line

Address (Street, Apt. Number)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Other Contact Info. (Time Available, Interpreter, etc.)

SU

SP

EC

TO

RM

ISS

ING

PE

RS

ON

S

Hair Color

Suspect Code Code

Maiden Name

Occupation

Driver's License State/Number

Employer/School

Immigration and Naturalization Number Other ID. Number

Address

Place of Birth Residence Phone

Business Phone

Social Security Number

OBTS Number

Date of Birth or Age Height

Complexion Facial Hair Teeth Speech/Voice Special Identifiers

Eye Color Hair Length Hair Style

Name (Last, First, Middle)

Clothing (Describe)

Last Known Address (Street, Apt. Number)

OFF/INC Indicator

1.#12.#2

Sex

Nickname/Street Name

SCIC/NCIC

WeightRace

Juvenile

Build

3.Both

City

Maiden Name

Occupation

Driver's License State/Number

Employer/School

Immigration and Naturalization Number Other ID. Number

Address

Place of Birth Residence Phone

Business Phone

Social Security Number

OBTS Number

Date of Birth Height

Complexion Facial Hair Teeth Speech/Voice Special Identifiers

Eye Color Hair Length Hair Style

State Zip

Clothing (Describe)

Last Known Address (Street, Apt. Number)

Sex

Nickname/Street Name

SCIC/NCIC

Hair ColorWeightRace

Build

Code Name (Last, First, Middle)OFF/INC Indicator

1.#12.#2

Juvenile

3.Both

Susp. #

E-EscapeeM-Missing

Suspect Code

S-SuspectA-Arrestee

R-Rec. MissingZ-other

Susp. #

Age

V. Type

E-EscapeeM-Missing

S-SuspectA-Arrestee

R-Rec. MissingZ-other

Injury Type(s)

ZipStateCity

Scars/Marks/Tatoos (Location/Describe)

Scars/Marks/Tatoos (Location/Describe)

MIS

SIN

GP

ER

SO

N/

RU

NA

WA

Y 7. VoluntaryAdult

8. Unknown

1. Yes2. No8. Unknown

Incident Type

1. Runaway2. Parental3. Involuntary

Foul Play Suspected ?

1. Yes2. No

Missing Before ?

1. Yes2. No8. Unknown

1. Yes2. No8. Unknown

1. Yes2. No8. Unknown

MCIC Form Provided ?

4. Disabled5. Endangered6. Disaster Victim

Fingerprints Available? Dental Record Available

1. Yes2. No

Photo Available?

Date Last Seen Time Last Seen Accompanied By

Property Carried

Probable Destination

Medication Required/Type

ID. Type/Number

Recovery Information7. Deceased9. Other

Doctor/Dentist (Name, Phone Number)

Transportation Mode

Location Last Seen (Address, City, St.)

5. Law Enforcement Custody6. Returned to Parent

3. Hospitalized4. HRS Custody

2. Located-Not Returned

0. N/A1. Voluntary

Name/Address

ID. Type/Number

Mental/Physical Condition

AD

MIN

IST

RA

TIV

E

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reporting

__/__/____

08/25/2017

__/__/____

08/25/2017

USA Rev. 01/23/2003

__/__/____

Signature of Officer Reviewing

YYeess NNoo

YYeess NNoo

C O P

Y

Page 11: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Type

Type

Type

Code Person

Code Person

Code Person

Code Person

Code Person

Holmes Beach Police Department20170711

0.00

0.00

326

SGT.COPEMAN

BORES

307

1

WARRANT STATE OF FLORIDA

TH

EF

TA

DM

A. Auto Accessory/PartsB. BicycleC. Camera/Photo EquipmentD. Drug

T. TV/Video/VCRU. Currency/NegotiableV. Credit Card/Non-NegotiableW. Boat MotorX. Structure

Property TypeO. Office EquipmentP. Art/CollectionQ. Computer EquipmentR. Radio/StereoS. Sports Equipment

E. Equipment/Tool.F. Food/Liquor/ConsumableG. GunH. Household Appliance/GoodsI. Plant/Citrus

J. Jewelry/Precious MetalK. Clothing/FurL. LivestockM. Musical InstrumentN. Construction Machinery

Date of Supplement

Original Date Reported Primary Offense Description Victim #1 Name (Last, First, Middle)

Agency Report Number

1. Original2. SupplementPROPERTY REPORT

Y. Farm EquipmentZ. Miscellaneous

PR

OP

.D

ET

AIL

/N

AR

R.

CO

DE

S

09. From Vehicle10. Extortion

Theft Type Codes

04. Pocket Picking05. Purse Snatching

06. Embezzlement07. From Coin Oper. Machine

08. From PublicAccess Building

11. By Computer12. Fraud

99. Other00. N/A01. Burglary

02. Robbery03. Shoplifting

Theft Type

A - ArresteeO - Other

1. Stolen2. Recovered

V - VictimS - Suspect

5. Lost6. Found

Person Codes Status Codes

3. Stolen and Recovered4. Recovered for Other Jurisdiction

2. Criminal Mischief3. During other Offense

7. Safekeeping8. Evidence/Seized

9. Other9. Other

Damage Codes

0. N/A1. Arson

PR

OP

ER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PropertyStolen

PropertyRecovered

Change in PropertyStolen Value

Change in PropertyRecovered Value

Activity Type Unit

Activity Description Quantity Unit

P. PossessS. SellB. BuyT. Traffic

R. SmuggleD. DeliverE. UseK. Dispense/Distribute

M. Manufacture/Produce/CultivateZ. Other

A. AmphetamineB. BarbiturateC. CocaineE. Heroin

H. HallucinogenM. MarijuanaO. Opium/DerivativeP. Paraphernalia/Equipment

S. SyntheticU. UnknownZ. Other

1. Gram2. Milligram3. Kilogram4. Ounce

5. Pound6. Ton7. Liter8. Milliliter

Estimated Street Value

TO

TA

LS

CO

DE

SD

RU

GS

PR

OP

ER

TY

Serial Number

NameItem # Status Damage Property Type Quantity BrandModel Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem # Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Activity Description Quantity Unit Estimated Street Value

Activity Description Quantity Unit Estimated Street Value

AD

MIN

IST

RA

TIV

E

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reviewing

Signature of Officer Reporting

9. Dose Unit/Item

__/__/____

08/25/2017

__/__/____

__/__/____

__/__/____

__/__/____

__/__/____

08/25/2017

__/__/____

USA Rev. 01/23/2003

C O P

Y

Page 12: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

AD

M

1100.. OOtthheerr -- SSppeecc..66.. TTrraannss..

77.. EEnnggiinnee PPaarrttss

1. Key

11.. KKeeyy

3. Hot Wire

6. Trans.

7. Engine Parts

8. Major Body Parts

VE

HIC

LE

/V

ES

SE

L1. Original2. Supplement

Date of Supplement

Reg. State

Date Recovered

LengthVessel Name

StyleModelStatusPerson #

1. Local / Local

2. Local / Other

3. Other / Local

Tag Type

Primary Offense Description Victim #1 Name (Last, First, Middle)

Person Code Status Code Damage Code Type Recovery Location Recovery Code

Stolen / Recovered

Holmes Beach Police Department

1. Stolen2. Recovered3. Stolen and

Recovered4. Suspicious

5. Impounded6. Abandoned7. Fail Return8. Seized9. Other

0. N / A1. Arson2. Criminal Mischief3. During Other Offense

1. Auto2. Truck / Van3. Motorcycle4. Camper / RV5. Bus

6. Trailer7. Boat8. Aircraft9. Other

VEHICLE REPORT

Original Date Reported

Agency Report Number

Description (Identifying Characteristics, Noticeable Damage, Interior Color, etc)

Tag Reg./Doc. # Reg. Year Decal Number

VIN/Hull/FAA Estimated Value

Propulsion

Insurance Company Lien HolderCondition

Hull Material Boat Type

Recovery Address/Geographic Indicator

Recovery Loc. Recovery Code Original Reporting Agency Report Number Reason/Authority

SCIC/NCIC Location of Original Theft

Value Recovered

1. Window Closed

ICTH04

1HTMMMML3JH679270

2. Locked 3. Keys in Ignition

WHITE

Color (Top/Bottom)

Towed By

Components Stripped

0. N/A 5. Interior 9. Tag/Decal Stolen

10. Other - Spec.0. N/A 8. Unk.2. Tow Truck 4. Steering

5. Ignition 1. VIN Plt.

4. Battery

Person Code Damage Type Year Make

2018 INTL TRK BOX

Storage Location

V- VictimS- SuspectA- ArresteeO- Other

5. Park / Playground6. Shopping Mall7. Woods8. Water9. Other

1. Family Residence2. Apt. Complex3. Housing Project4. Commercial /

Industrial

4. Stripped / TheftFrom

9. Other

CO

DE

SV

EH

ICL

E/V

ES

SE

LV

EH

ICL

EIN

V./N

AR

RA

TIV

E

Person Code Person # Status Damage StyleModelType Year Make

Reg. State Tag TypeTag Reg./Doc. # Reg. Year Decal Number

VIN/Hull/FAA Estimated Value

Insurance Company Lien HolderCondition

1. Window Closed1. Window Closed 2. Locked2. Locked 3. Keys in Ignition3. Keys in Ignition

Description (Identifying Characteristics, Noticeable Damage, Interior Color, etc)Color (Top/Bottom)

LengthVessel Name PropulsionHull Material Boat Type

Date RecoveredRecovery Address/Geographic Indicator Value Recovered

Recovery Loc. Recovery Code Original Reporting Agency Report Number Reason/Authority

Methodof Theft

00.. NN//AA 88.. UUnnkk..22.. TTooww TTrruucckk

33.. HHoott WWiirree

44.. SStteeeerriinngg

55.. IIggnniittiioonn

Components Stripped

00.. NN//AA 55.. IInntteerriioorr

88.. MMaajjoorr BBooddyy PPaarrttss

99.. TTaagg//DDeeccaall SSttoolleenn11.. VVIINN PPlltt..

44.. BBaatttteerryy

Location of Original TheftTowed By Storage Location SCIC/NCIC

Vehicle #

HoldY - YesN - No

HoldY - YesN - No

Vehicle #

Methodof Theft

2. Tires/Wheels

3. Radio/CB

22.. TTiirreess//WWhheeeellss

33.. RRaaddiioo//CCBB

FL

Case Status

Routed To Referred To

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

BORES

SGT.COPEMAN 307

326

Arrest Number

20170711

WARRANT STATE OF FLORIDA

11 09A 2

1

2017

__/__/____

__/__/____

08/25/2017

__/__/____

__/__/____

USA Rev. 01/21/2003

__/__/____

08/25/2017

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Page 13: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

1. Offense

2. Arrest

Juvenile

Warn/Dismiss

1. Original

2. Supplement

AD

M

Holmes Beach Police DepartmentFL0410400 20170711

1 1

BORES

SGT.COPEMAN 307

326

NA

RR

AT

IVE

Original Date Reported

NARRATIVE CONTINUATION

Case Reference

Date of Supplement Agency ORI Number Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

08/25/2017

08/25/2017

__/__/____

__/__/____

USA Rev. 01/23/2003

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

Page 14: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

3110/19/1985

FL0410400

03

00

1403

1 1 1 00 00

VICKERS

5610 SOLITAIRE PALM WAY 33572APOLLO BEACH

V262165853790

606

Holmes Beach Police Department

1403 1403 1440

20170716

DAVID EARL

THEFT

01

Sat

Mon Sat

01 WOLFE

206 PEACOCK LN HOLMES BEACH 34217

29

MELISA SUSAN

2 FW

MW

V 3

2S

BLU BLD

1 1 0 00 1600

FL

FL

LT MED B

FL

PATROL

J. PIERCE

SGT.K.POWERS 320

DET

014 1 230G812CTHEFT/fOTHERS

___-_______

___-__-____

941 822-3986

___-_______

___ ___-____

___-_______

___ ___-____

X

34217PEACOCK LN HOLMES BEACH206

2 0

1

1

309

1

LAPTOP AND STEREO OWNER

TATTOOS

N2 1

00. N/A

01. Gunshot

02. Stabbed

OFF/INC Indicator

EV

EN

TD

AT

AN

AR

RA

TIV

ES

US

PE

CT

CO

DE

SA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer

22. Landlord/Tenant

23. Acquaintance

99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims

00. N/A01. Handgun

05. Knife/CuttingInstrument

06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - Victim

W - Witness

C - Reporting Person

O - Other

Race

N - N/A

M - Male

F - Female

U - Unknown

Residence Type

0. N/A

1. City

2. County

Extent of InjuryResidence Status

03. Laceration

04. Unconscious

05. Poss. Broken Bones

06. Poss. Internal Injury

Victim Relationship To Offender07. Loss of Teeth

08. Burns

09. Abrasions/Bruises

99. Other

06. Parent

07. Brother/Sister

08. Child

09. Step-Parent

10. Step-Child

11. In-Law

12. Other Family

13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend

18. Neighbor

19. Sitter/Day Care

20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type0. N/A

1. Juvenile

2. L.E. Officer

3. Adult

4. Business

5. Government

6. Church

9. Other

Sex

I - American Indian

O - Oriental/Asian

U - Unknown

N - N/A

W - White

B - Black

3. Florida

4. Out-of-State

0. N/A

1. Full Year

2. Part Year

3. Non-Resident

0. None

1. Minor

2. Serious

3. Fatal

14. Teacher

15. Child of Boy/Girl

Friend

16. Boy/Girl Friend

03. Spouse

04. Ex-Spouse

05. Co-Habitant

00. N/A

01. Undetermined

02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

If V/W Code isV, W or C

Fill in this LineOFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2

3.Both

Date of Birth Age

Date of Birth Age

If V/W Code isV, W or C

Fill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Age

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type2. Arrest on Primary Offense

Secondary Offense Without Prosecution3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____

08/26/2017

08/21/2017 08/26/2017

__/__/____

08/27/2017

__/__/____

USA Rev. 01/21/2003

12/26/1987

Signature of Officer Reporting

Signature of Officer Reviewing

Yes No

YYeess NNoo

C O P

Y

Page 15: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Type

Type

Type

Holmes Beach Police Department20170716

45126AHQF5W

1

APPLE MACBOOK

APPLE1 LAPTOP01 MACBOOK

170X1164

1

JVC

JVC1 STEREO01 KD-R775S

0

V 0

Q

R

1,499.00

300.00

1

1

00

APPLE MACBOOKJVC STEREO

1,799.00

0.00

PATROL

DET

309

SGT.K.POWERS

J. PIERCE

320

1

THEFT WOLFE MELISA SUSAN

V

TH

EF

TA

DM

A. Auto Accessory/PartsB. BicycleC. Camera/Photo EquipmentD. Drug

T. TV/Video/VCRU. Currency/NegotiableV. Credit Card/Non-NegotiableW. Boat MotorX. Structure

Property TypeO. Office EquipmentP. Art/CollectionQ. Computer EquipmentR. Radio/StereoS. Sports Equipment

E. Equipment/Tool.F. Food/Liquor/ConsumableG. GunH. Household Appliance/GoodsI. Plant/Citrus

J. Jewelry/Precious MetalK. Clothing/FurL. LivestockM. Musical InstrumentN. Construction Machinery

Date of Supplement

Original Date Reported Primary Offense Description Victim #1 Name (Last, First, Middle)

Agency Report Number

1. Original2. SupplementPROPERTY REPORT

Y. Farm EquipmentZ. Miscellaneous

PR

OP

.D

ET

AIL

/N

AR

R.

CO

DE

S

09. From Vehicle10. Extortion

Theft Type Codes

04. Pocket Picking05. Purse Snatching

06. Embezzlement07. From Coin Oper. Machine

08. From PublicAccess Building

11. By Computer12. Fraud

99. Other00. N/A01. Burglary

02. Robbery03. Shoplifting

Theft Type

A - ArresteeO - Other

1. Stolen2. Recovered

V - VictimS - Suspect

5. Lost6. Found

Person Codes Status Codes

3. Stolen and Recovered4. Recovered for Other Jurisdiction

2. Criminal Mischief3. During other Offense

7. Safekeeping8. Evidence/Seized

9. Other9. Other

Damage Codes

0. N/A1. Arson

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PropertyStolen

PropertyRecovered

Change in PropertyStolen Value

Change in PropertyRecovered Value

Activity Type Unit

Activity Description Quantity Unit

P. PossessS. SellB. BuyT. Traffic

R. SmuggleD. DeliverE. UseK. Dispense/Distribute

M. Manufacture/Produce/CultivateZ. Other

A. AmphetamineB. BarbiturateC. CocaineE. Heroin

H. HallucinogenM. MarijuanaO. Opium/DerivativeP. Paraphernalia/Equipment

S. SyntheticU. UnknownZ. Other

1. Gram2. Milligram3. Kilogram4. Ounce

5. Pound6. Ton7. Liter8. Milliliter

Estimated Street Value

TO

TA

LS

CO

DE

SD

RU

GS

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Activity Description Quantity Unit Estimated Street Value

Activity Description Quantity Unit Estimated Street Value

AD

MIN

IST

RA

TIV

E

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reviewing

Signature of Officer Reporting

9. Dose Unit/Item

__/__/____

08/26/2017

__/__/____

__/__/____

__/__/____

__/__/____

__/__/____

08/27/2017

__/__/____

USA Rev. 01/21/2003

C O P

Y

Page 16: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Holmes Beach Police Department

THEFT

FL0410400 20170716

1 1

DET

PATROL

J. PIERCE

SGT.K.POWERS 320

309

ON 08-27-17 I RESPONDED TO 5801 MARINA DR TO TAKE A THEFT REPORT FROM THE VICTIM (MELISA WOLFE). SHE

ADVISED THAT SHE HAD BEEN AT THE HOSPITAL TENDING TO HER CHILD FOR A FEW DAYS AND WHEN SHE RETURNED ON

08-25-17 SHE OBSERVED ITEMS MISSING FROM HER RESIDENCE AND HER VEHICLE. SHE STATED THAT SHE CONFRONTED

HER BOYFRIEND (DAVID VICKERS)OVER THE INCIDENT AFTER FINDING A WATER BOTTLE WITH A PAWN LOGO ON IT

INSIDE HER VEHICLE. HE THEN ADMITTED TO HER THAT HE HAD PAWNED HER SPEAKERS AND HER CAR STEREO. WOLFE

TOLD HIM THAT HE DID NOT HAVE PERMISSION TO PAWN ANY OF HER BELONGINGS. SHE ALSO OBSERVED HER LAPTOP

MISSING AND WAS UNABLE TO FIND IT IN HER RESIDENCE WHERE SHE LEFT IT. AFTER FINDING THE WATER BOTTLE

IN HER CAR WITH THE PAWN LOGO ON IT, SHE DECIDED TO GO TO SOME OF THE PAWN SHOPS WHERE SHE OBTAINED A

RECEIPT SHOWING VICKERS PAWNING HER STEREO AT ABBA PAWN IN BRADENTON ON 08-21-17. I RAN VICKERS

THROUGH THE PAWN DATABASE AND FOUND WOLFE'S STOLEN LAPTOP HAD BEEN PAWNED BY VICKERS AT AMERICAS

SUPERPAWN ON 08-23-17. WOLFE PROVIDED THE RECEIPT FOR HER LAPTOP WITH THE MATCHING SERIAL NUMBER AND

THE VALUE OF $1499. HER JVC STEREO IS VALUED AT $300. I PLACED THE WATER BOTTLE FROM THE PAWN SHOP

THAT WAS FOUND IN THE VICTIM'S VEHICLE WHERE HER STEREO HAD BEEN TAKEN, INTO PROPERTY AND EVIDENCE.

VICTIM WOLFE FILLED OUT AN AFFIDAVIT CONCERNING HER CONFRONTATION WITH DAVID VICKERS OVER HER STOLEN

PROPERTY AND PROVIDED THE RECEIPTS FOR THE STOLEN LAPTOP AND RECEIPT FROM ABBA PAWN. I NOTIFIED

DET-SGT HALL CONCERNING THE CASE.

NA

RR

AT

IVE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense

2. Arrest

Juvenile

Warn/Dismiss

1. Original

2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

08/26/2017

08/27/2017

__/__/____

__/__/____

USA Rev. 01/21/2003

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Page 17: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Holmes Beach Police Department 20170716

5610 SOLITAIRE PALM WAY

V262165853790

606

33572APOLLO BEACH

31 290

VICKERS DAVID E1 2A

FL

MW

N 2

BLU BLD X

FL

HEV

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

813 468-8565

___-__-____

___-_______

___ ___-____

311DET SGT HALL

THEFT WOLFE MELISA

NUMEROUS

1

CO

DE

SA

DM

Juvenilein Report:

Date of Supplement

Primary Offense Description

Victim Type Race

Victim Relationship To Offender

Agency Report Number

Residence Type Residence Status4. Business5. Government6. Church9. Other

SexN-N/AM-MaleF-FemaleU-Unknown

0. N/A1. City2. County

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

00. N/A01. Undetermined02. Stranger

03. Spouse04. Ex-Spouse05. Co-Habitant

06. Parent07. Brother/Sister08. Child09. Step-Parent

14. Teacher15. Child of Boy/Girl Friend16. Boy/Girl Friend

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

PERSON(S) REPORT

Injury Type

00. N/A01. Gunshot02. Stabbed

Original Date Reported

1. Original2. Supplement:

0. N/A1. Juvenile2. L.E. Officer3. Adult

N-N/AW-WhiteB-Black

I-American IndianO-Oriental/AsianU-Unknown

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

10. Step-Child11. In-Law12. Other Family13. Student

Victim #1 Name (Last, First, Middle)

V/W CodeV - VictimW - WitnessC - Reporting Person

O - Other

Will Victim prefer charge?

Will Victim prefer charge?

Extent of Injury

SU

SP

EC

TO

RM

ISS

ING

PE

RS

ON

S

If V/W Code isV, W or C

Fill in this LineOFF/INC Indicator

OFF/INC Indicator V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Relationship Ethnicity

Synopsis of Involvement

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2 3.Both

Date of Birth Age

Date of Birth Age

If V/W Code isV, W or C

Fill in this Line

Address (Street, Apt. Number)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Other Contact Info. (Time Available, Interpreter, etc.)

SU

SP

EC

TO

RM

ISS

ING

PE

RS

ON

S

Hair Color

Suspect Code Code

Maiden Name

Occupation

Driver's License State/Number

Employer/School

Immigration and Naturalization Number Other ID. Number

Address

Place of Birth Residence Phone

Business Phone

Social Security Number

OBTS Number

Date of Birth or Age Height

Complexion Facial Hair Teeth Speech/Voice Special Identifiers

Eye Color Hair Length Hair Style

Name (Last, First, Middle)

Clothing (Describe)

Last Known Address (Street, Apt. Number)

OFF/INC Indicator

1.#12.#2

Sex

Nickname/Street Name

SCIC/NCIC

WeightRace

Juvenile

Build

3.Both

City

Maiden Name

Occupation

Driver's License State/Number

Employer/School

Immigration and Naturalization Number Other ID. Number

Address

Place of Birth Residence Phone

Business Phone

Social Security Number

OBTS Number

Date of Birth Height

Complexion Facial Hair Teeth Speech/Voice Special Identifiers

Eye Color Hair Length Hair Style

State Zip

Clothing (Describe)

Last Known Address (Street, Apt. Number)

Sex

Nickname/Street Name

SCIC/NCIC

Hair ColorWeightRace

Build

Code Name (Last, First, Middle)OFF/INC Indicator

1.#12.#2

Juvenile

3.Both

Susp. #

E-EscapeeM-Missing

Suspect Code

S-SuspectA-Arrestee

R-Rec. MissingZ-other

Susp. #

Age

V. Type

E-EscapeeM-Missing

S-SuspectA-Arrestee

R-Rec. MissingZ-other

Injury Type(s)

ZipStateCity

Scars/Marks/Tatoos (Location/Describe)

Scars/Marks/Tatoos (Location/Describe)

MIS

SIN

GP

ER

SO

N/

RU

NA

WA

Y 7. VoluntaryAdult

8. Unknown

1. Yes2. No8. Unknown

Incident Type

1. Runaway2. Parental3. Involuntary

Foul Play Suspected ?

1. Yes2. No

Missing Before ?

1. Yes2. No8. Unknown

1. Yes2. No8. Unknown

1. Yes2. No8. Unknown

MCIC Form Provided ?

4. Disabled5. Endangered6. Disaster Victim

Fingerprints Available? Dental Record Available

1. Yes2. No

Photo Available?

Date Last Seen Time Last Seen Accompanied By

Property Carried

Probable Destination

Medication Required/Type

ID. Type/Number

Recovery Information7. Deceased9. Other

Doctor/Dentist (Name, Phone Number)

Transportation Mode

Location Last Seen (Address, City, St.)

5. Law Enforcement Custody6. Returned to Parent

3. Hospitalized4. HRS Custody

2. Located-Not Returned

0. N/A1. Voluntary

Name/Address

ID. Type/Number

Mental/Physical Condition

AD

MIN

IST

RA

TIV

E ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

USA Rev. 01/21/2003

__/__/____

__/__/____

__/__/____

08/31/2017

08/25/2017

10/19/1985

Signature of Officer Reporting

Signature of Officer Reviewing

YYeess NNoo

YYeess NNoo

C O P

Y

Page 18: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

NA

RR

AT

IVE

Original Date Reported

NARRATIVE CONTINUATION

THEFT

Holmes Beach Police Department

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense

2. Arrest

Juvenile

Warn/Dismiss

1. Original

2. Supplement

Agency Report Number

FL0410400 20170716

1 2

ON 08-29-2017, I WENT TO THE ABBA PAWN SHOP, 5681 15TH ST E. BRADENTON, WHERE THE VICTIM

HAD FOUND HER CAR STEREO PAWNED BY HER LIVE IN BOYFRIEND. I ALSO SEARCHED THE RAPID

PAWN DATABASE AND CONFIRMED THAT HE HAD SOLD THE STEREO THERE. I ALSO LOCATED THE

STOLEN LAPTOP AT THE AMERICA SUPER PAWN #3, 5137 14TH ST W. BRADENTON. I PLACED A HOLD

ON BOTH OF THE ITEMS AND PHOTOGRAPHED THE ITEMS. I MATCHED THE SERIAL NUMBER ON THE

LAPTOP TO THE RECEIPT PROVIDED BY THE VICTIM. I TOOK POSSESSION OF THE ORIGINAL PAWNSLIPS.

I TOOK THE PAWN SLIPS TO THE MCSO FINGERPRINT UNIT. THE THUMB PRINT WAS CONFIRMED TOBE THE RIGHT THUMB PRINT OF DAVID VICKERS ON BOTH SLIPS.

ON 08-30-2017, A WARRANT WAS SIGNED FOR GRAND THEFT OF THE ITEMS. THE WARRANT WAS

DELIVERED TO THE JAIL, AS THE DEFENDANT WAS ALREADY INCARCERATED. THE MANATEE

COUNTY SHERIFF'S OFFICE WROTE THE WARRANTS FOR THE PAWN FRAUD AND DEALING IN STOLENPROPERTY. THIS CASE IS CLEARED WITH AN ARREST.

Case Status

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

111 ACA

DET SGT HALL 311

Report Contains

Arrest Number

__/__/____

__/__/____

08/31/2017

USA Rev. 01/23/2003

08/31/2017

08/26/2017

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

Page 19: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

FL0410400

01

00

1035

1 1 UK 1 0

UNKNOWN

Holmes Beach Police Department

1035 1040 1207

0800 1035

20170717 BURGLARY

Mon

Fri Mon

1 HUMES

105 7TH ST. N. BRADENTON BEACH 34217

56

1

517 71ST ST. HOLMES BEACH 34217

WF74

JAMES FRED

BOLAY BRENDA

2

2

MW

W

C 3

V 3

S

2

1

1

1

0

0

00

00

17

0100

00

FL

FL

1

JASON HIGGINS

SGT.COPEMAN 307

DET

2 3b 2200810CBURGLARY

___-_______

___-__-____

941 779-0100

___-_______

941 704-4745

___-_______

___ ___-____

34217 W80

RESIDENCE

71ST STREET HOLMES BEACH517

1 2

1

1

1

3

331

1

CARETAKER

OWNER OF HOUSE

WM

F

SEE SECOND PAGE NARRATIVE.

N2 1

00. N/A

01. Gunshot

02. Stabbed

OFF/INC Indicator

EV

EN

TD

AT

AN

AR

RA

TIV

ES

US

PE

CT

CO

DE

SA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer

22. Landlord/Tenant

23. Acquaintance

99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims

00. N/A01. Handgun

05. Knife/CuttingInstrument

06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - Victim

W - Witness

C - Reporting Person

O - Other

Race

N - N/A

M - Male

F - Female

U - Unknown

Residence Type

0. N/A

1. City

2. County

Extent of InjuryResidence Status

03. Laceration

04. Unconscious

05. Poss. Broken Bones

06. Poss. Internal Injury

Victim Relationship To Offender07. Loss of Teeth

08. Burns

09. Abrasions/Bruises

99. Other

06. Parent

07. Brother/Sister

08. Child

09. Step-Parent

10. Step-Child

11. In-Law

12. Other Family

13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend

18. Neighbor

19. Sitter/Day Care

20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type0. N/A

1. Juvenile

2. L.E. Officer

3. Adult

4. Business

5. Government

6. Church

9. Other

Sex

I - American Indian

O - Oriental/Asian

U - Unknown

N - N/A

W - White

B - Black

3. Florida

4. Out-of-State

0. N/A

1. Full Year

2. Part Year

3. Non-Resident

0. None

1. Minor

2. Serious

3. Fatal

14. Teacher

15. Child of Boy/Girl

Friend

16. Boy/Girl Friend

03. Spouse

04. Ex-Spouse

05. Co-Habitant

00. N/A

01. Undetermined

02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

If V/W Code isV, W or C

Fill in this LineOFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2

3.Both

Date of Birth Age

Date of Birth Age

If V/W Code isV, W or C

Fill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Age

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type2. Arrest on Primary Offense

Secondary Offense Without Prosecution3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____

08/28/2017

07/28/2017 08/28/2017

__/__/____

08/28/2017

__/__/____

USA Rev. 01/21/2003

12/06/1960

11/19/1942

Signature of Officer Reporting

Signature of Officer Reviewing

YYeess NNoo

Yes No

C O P

Y

Page 20: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Type

Type

Type

Holmes Beach Police Department20170717

N/A N/A

1

WHITE DOOR (FRONT OF HOUSE) DAMAGED

STANDARD1 FRONT DOOR1

N/A N/A MISC. COINS, NO DESCRIPTION.

MISC2 COINS1

N/A N/A MISC. WOMEN'S JEWELRY

MISC3 NECKLACES1

N/A N/A

1

MEDIUM-HEAVY BRONZE SAFE, DAMAGED.

STEEL4 SAFE1

N/A N/A

1

LARGE RUBBER MALLET.

LARGE5 RUBBER MALLET1

3

V

V

V

R

3

3

3

3

Z

J

J

Z

E

200.00

100.00

100.00

600.00

9

1

9

8

1

01

1. HOUSE'S FRONT DOOR HAD BEEN PRIED OPEN WITH A CROWBAR OR IT'S EQUIVALENT, AND DAMAGED BY THAT;2. COINS, WITH NO DESCRIPTION WERE STOLEN FROM SAFE;3. UNKNOWN AMOUNT OF NECKLACES WITHOUT DESCRIPTION;4. RUBBER MALLET, USED TO BREAK INTO THE SAFE;

1,000.00

0.00

DET

331

SGT.COPEMAN

JASON HIGGINS

307

32

1

BURGLARY HUMES JAMES FRED

V

TH

EF

TA

DM

A. Auto Accessory/PartsB. BicycleC. Camera/Photo EquipmentD. Drug

T. TV/Video/VCRU. Currency/NegotiableV. Credit Card/Non-NegotiableW. Boat MotorX. Structure

Property TypeO. Office EquipmentP. Art/CollectionQ. Computer EquipmentR. Radio/StereoS. Sports Equipment

E. Equipment/Tool.F. Food/Liquor/ConsumableG. GunH. Household Appliance/GoodsI. Plant/Citrus

J. Jewelry/Precious MetalK. Clothing/FurL. LivestockM. Musical InstrumentN. Construction Machinery

Date of Supplement

Original Date Reported Primary Offense Description Victim #1 Name (Last, First, Middle)

Agency Report Number

1. Original2. SupplementPROPERTY REPORT

Y. Farm EquipmentZ. Miscellaneous

PR

OP

.D

ET

AIL

/N

AR

R.

CO

DE

S

09. From Vehicle10. Extortion

Theft Type Codes

04. Pocket Picking05. Purse Snatching

06. Embezzlement07. From Coin Oper. Machine

08. From PublicAccess Building

11. By Computer12. Fraud

99. Other00. N/A01. Burglary

02. Robbery03. Shoplifting

Theft Type

A - ArresteeO - Other

1. Stolen2. Recovered

V - VictimS - Suspect

5. Lost6. Found

Person Codes Status Codes

3. Stolen and Recovered4. Recovered for Other Jurisdiction

2. Criminal Mischief3. During other Offense

7. Safekeeping8. Evidence/Seized

9. Other9. Other

Damage Codes

0. N/A1. Arson

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PropertyStolen

PropertyRecovered

Change in PropertyStolen Value

Change in PropertyRecovered Value

Activity Type Unit

Activity Description Quantity Unit

P. PossessS. SellB. BuyT. Traffic

R. SmuggleD. DeliverE. UseK. Dispense/Distribute

M. Manufacture/Produce/CultivateZ. Other

A. AmphetamineB. BarbiturateC. CocaineE. Heroin

H. HallucinogenM. MarijuanaO. Opium/DerivativeP. Paraphernalia/Equipment

S. SyntheticU. UnknownZ. Other

1. Gram2. Milligram3. Kilogram4. Ounce

5. Pound6. Ton7. Liter8. Milliliter

Estimated Street Value

TO

TA

LS

CO

DE

SD

RU

GS

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Activity Description Quantity Unit Estimated Street Value

Activity Description Quantity Unit Estimated Street Value

AD

MIN

IST

RA

TIV

E

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reviewing

Signature of Officer Reporting

9. Dose Unit/Item

__/__/____

08/28/2017

08/28/2017

__/__/____

__/__/____

08/28/2017

__/__/____

08/28/2017

__/__/____

USA Rev. 01/21/2003

C O P

Y

Page 21: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Holmes Beach Police DepartmentFL0410400 20170717

1 1

DET

33

JASON HIGGINS

SGT.COPEMAN 307

331

I RESPONDED TO 517 71ST ST., HOLMES BEACH, FL. FOR A BURGLARY TO RESIDENCE. UPON ARRIVAL, I MET

WITH CARETAKER OF PROPERTY, JAMES HUMES. HUMES PARKS HIS BOAT BEHIND RESIDENCE AND IS CURRENTLY TAKING

CARE OF THE PROPERTY BY CHECKING THE INTERIOR OF THE DWELLING TO MAKE SURE IT IS SECURE. APPROXIMATELY

A MONTH AGO, THE PROPERTY OWNER, BRENDA BOLAY, LEFT TO GO OUT-OF-STATE. AND THIS WAS THE FIRST TIME HE

HAD BEEN THERE TO CHECK THE INSIDE.

TODAY, HUMES WENT TO THE FRONT DOOR AND NOTICED THE BOTTOM LOCK WAS LOCKED. WHEN HE OPENED THE

DOOR HE COULD CLEARLY SEE THAT THE DEADBOLT WAS MISSING AND THE DOOR WAS DAMAGED FROM A CROWBAR OR

SOME OTHER PRYING INSTRUMENT BEING USED AS THE TOOL TO GAIN ENTRY TO THE RESIDENCE. HUMES WENT INSIDE

AND NOTICED THE SAFE LAYING ON THE GROUND ON A RUG IN THE OFFICE. HUMES CALLED H.B.P.D. AS SOON AS HE

DISCOVERED THE BURGLARY.

THE SAFE WAS ORIGINALLY KEPT INSIDE A HALLWAY CLOSET--JUST RIGHT OUTSIDE THE OFFICE. THE BRONZE

SAFE WAS HEAVY, MEDIUM SIZED, AND LAYING ON IT'S BACK. THE DOOR WAS REMOVED BY SOMEONE REMOVING THE

PINS TO THE DOOR AND PRYING IT OPEN WITH AN UNKNOWN TOOL. THE DOOR WAS ON THE GROUND ALONG SIDE THE

METAL DRAWERS FROM THE SAFE. OFFICER STEVE OGLINE OBSERVED A LARGE RUBBER MALLET ON THE DESK LOCATED

INSIDE THE OFFICE, APPROXIMATELY 3 FEET AWAY FROM THE SAFE. HUMES SAID THAT THE MALLET LOOKS

OUT-OF-PLACE, AND DOESN'T BELONG TO THE HOUSE. OFFICER OGLINE TOOK A PICTURE OF MALLET AND IT'S

LOCATION AND SEIZED IT AS EVIDENCE. OFFICER OGLINE TOOK PICTURES OF THE SAFE AND THE FRONT DOOR.

I CANVASSED THE REST OF THE HOUSE FOR OTHER ENTRY OR EXIT POINTS. ALL WINDOWS AND DOORS AROUND

THE EXTERIOR OF THE HOUSE HAVE HURRICANE SHUTTERS ON THEM AND WERE SECURE. HUMES AND I, WALKED THROUGH

THE ROOMS, AND WE COULD NOT LOCATE ANYTHNG ELSE THAT WAS DISTURBED.

I DUSTED THE SAFE AND DRAWERS FOR FINGERPRINTS AND WAS UNABLE TO LOCATE ANY. I DUSTED THE FRONT

DOOR AND WAS ABLE TO FIND LAYERS OF SMUDGES FROM WHERE PEOPLE HAD PULLED THE DOOR OPEN, APPROXIMATELY

A FOOT ABOVE THE DEADBOLT.

I SPOKE TO HOME OWNER AND SHE SAID THE CONTENTS INSIDE THE SAFE WERE: ASSORTED NECKLACES AND

COINS WITH A TOTAL VALUE AT $200.00. SHE WAS UNABLE TO GIVE ME A DESCRIPTION OF CONTENTS THEREIN.

HUMES WAS ISSUED A CASE NUMBER, CARD, AND TOLD TO CALL H.B.P.D. TO FOLLOW UP WITH US IF ANYTHING ELSE

WAS STOLEN WHEN SHE RETURNS.

NA

RR

AT

IVE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense

2. Arrest

Juvenile

Warn/Dismiss

1. Original

2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

08/28/2017

08/28/2017

__/__/____

__/__/____

USA Rev. 01/21/2003

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Page 22: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

NA

RR

AT

IVE

Original Date Reported

NARRATIVE CONTINUATION

BURGLARY (DWELLING)

Holmes Beach Police Department

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense

2. Arrest

Juvenile

Warn/Dismiss

1. Original

2. Supplement

Agency Report Number

FL0410400 20170717

1 2

I RESPONDED TO 517 71st STREET TO ASSIST OFC HIGGINS WITH A BURGLARY INVESTIGATION. UPON ARRIVAL, I

WALKED THE SCENE WITH OFC HIGGINS AND WE OBSERVED PRY MARKS ON THE FRONT DOOR, FRONT DOOR JAMB, AND

SAFE. WE ALSO LEARNED FROM THE COMPLAINANT THAT A RUBBER MALLET WAS LEFT ON THE DESK IN THE SOUTH-

WEST BEDROOM WHERE A SAFE HAD BEEN BROKEN INTO. I RETRIEVED MY DEPARTMENT ISSUED CAMERA AND TOOK A

SERIES OF 16 PHOTOGRAPHS DOCUMENTING THE SCENE FROM THE FRONT DOOR TO THE BEDROOM, INCLUDING THE

MALLET LYING ON THE DESK. I SECURED THE MALLET AS EVIDENCE AND LATER PUT IT INTO PROPERTY & EVIDENCE

ALONG WITH A LAB REQUEST FORM ASKING TO HAVE IT EXAMINED FOR POSSIBLE DNA AND FINGERPRINT EVIDENCE. I

ALSO UPLOADED THE DIGITAL IMAGES INTO THE CASE FILES DATABASE OF THE HBPD INTRANET. I TOOK NFA.

Case Status

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

OGLINE

SGT.COPEMAN 307

322

Report Contains

Arrest Number

08/28/2017

__/__/____

__/__/____

USA Rev. 01/23/2003

08/28/2017

08/28/2017

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

Page 23: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

FL0410400

01

03

1347

02 01 UK 02 00

Holmes Beach Police Department

1348 1353 1522

1500 1200

20170719 BURGLARY

Mon

Mon Sun

1 MOORE

502 72nd ST HOLMES BEACH 34217

86

BOBBY L

2 MW

V 3

1 2 0 00 0000

FL

OGLINE

SGT.COPEMAN 307

DET

2 2b 2200

2 4b 2200CBURGLARY

810

810

CBURGLARY

___-_______

___-__-____

863 648-7875

___-_______

___ ___-____

___-_______

___ ___-____

3421772nd STREET HOLMES BEACH502

1 2

1

1

3

322

SEE NARRATIVE

N2 1

00. N/A

01. Gunshot

02. Stabbed

OFF/INC Indicator

EV

EN

TD

AT

AN

AR

RA

TIV

ES

US

PE

CT

CO

DE

SA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer

22. Landlord/Tenant

23. Acquaintance

99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims

00. N/A01. Handgun

05. Knife/CuttingInstrument

06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - Victim

W - Witness

C - Reporting Person

O - Other

Race

N - N/A

M - Male

F - Female

U - Unknown

Residence Type

0. N/A

1. City

2. County

Extent of InjuryResidence Status

03. Laceration

04. Unconscious

05. Poss. Broken Bones

06. Poss. Internal Injury

Victim Relationship To Offender07. Loss of Teeth

08. Burns

09. Abrasions/Bruises

99. Other

06. Parent

07. Brother/Sister

08. Child

09. Step-Parent

10. Step-Child

11. In-Law

12. Other Family

13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend

18. Neighbor

19. Sitter/Day Care

20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type0. N/A

1. Juvenile

2. L.E. Officer

3. Adult

4. Business

5. Government

6. Church

9. Other

Sex

I - American Indian

O - Oriental/Asian

U - Unknown

N - N/A

W - White

B - Black

3. Florida

4. Out-of-State

0. N/A

1. Full Year

2. Part Year

3. Non-Resident

0. None

1. Minor

2. Serious

3. Fatal

14. Teacher

15. Child of Boy/Girl

Friend

16. Boy/Girl Friend

03. Spouse

04. Ex-Spouse

05. Co-Habitant

00. N/A

01. Undetermined

02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

If V/W Code isV, W or C

Fill in this LineOFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2

3.Both

Date of Birth Age

Date of Birth Age

If V/W Code isV, W or C

Fill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Age

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type2. Arrest on Primary Offense

Secondary Offense Without Prosecution3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____

08/28/2017

08/14/2017 08/27/2017

__/__/____

08/28/2017

__/__/____

USA Rev. 01/21/2003

07/03/1931

Signature of Officer Reporting

Signature of Officer Reviewing

Yes No

YYeess NNoo

C O P

Y

Page 24: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Type

Type

Type

Holmes Beach Police Department20170719

19

MISC BRANDS AND SIZES

1 FISHING REELS1

K2J733433

1

IN BOX

GLOBALSTAR2 SATELLITE PHONE1 GSP-1700

1

ORANGE PLASTIC W/ SCREW ON LID

3 GUN STORGE TUBE1

1

SMALL TAN/BRN RECT WOOD STOOL

4 STOOL1

10

CARDS

5 LATENT PRINTS1

0

V

V

V

V

0

0

0

0

S

Z

S

H

Z

5,000.00

1,000.00

50.00

50.00

0.00

1

1

1

8

1

01

6,100.00

0.00

DET

322

SGT.COPEMAN

OGLINE

307

1

BURGLARY MOORE BOBBY L

V

TH

EF

TA

DM

A. Auto Accessory/PartsB. BicycleC. Camera/Photo EquipmentD. Drug

T. TV/Video/VCRU. Currency/NegotiableV. Credit Card/Non-NegotiableW. Boat MotorX. Structure

Property TypeO. Office EquipmentP. Art/CollectionQ. Computer EquipmentR. Radio/StereoS. Sports Equipment

E. Equipment/Tool.F. Food/Liquor/ConsumableG. GunH. Household Appliance/GoodsI. Plant/Citrus

J. Jewelry/Precious MetalK. Clothing/FurL. LivestockM. Musical InstrumentN. Construction Machinery

Date of Supplement

Original Date Reported Primary Offense Description Victim #1 Name (Last, First, Middle)

Agency Report Number

1. Original2. SupplementPROPERTY REPORT

Y. Farm EquipmentZ. Miscellaneous

PR

OP

.D

ET

AIL

/N

AR

R.

CO

DE

S

09. From Vehicle10. Extortion

Theft Type Codes

04. Pocket Picking05. Purse Snatching

06. Embezzlement07. From Coin Oper. Machine

08. From PublicAccess Building

11. By Computer12. Fraud

99. Other00. N/A01. Burglary

02. Robbery03. Shoplifting

Theft Type

A - ArresteeO - Other

1. Stolen2. Recovered

V - VictimS - Suspect

5. Lost6. Found

Person Codes Status Codes

3. Stolen and Recovered4. Recovered for Other Jurisdiction

2. Criminal Mischief3. During other Offense

7. Safekeeping8. Evidence/Seized

9. Other9. Other

Damage Codes

0. N/A1. Arson

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PropertyStolen

PropertyRecovered

Change in PropertyStolen Value

Change in PropertyRecovered Value

Activity Type Unit

Activity Description Quantity Unit

P. PossessS. SellB. BuyT. Traffic

R. SmuggleD. DeliverE. UseK. Dispense/Distribute

M. Manufacture/Produce/CultivateZ. Other

A. AmphetamineB. BarbiturateC. CocaineE. Heroin

H. HallucinogenM. MarijuanaO. Opium/DerivativeP. Paraphernalia/Equipment

S. SyntheticU. UnknownZ. Other

1. Gram2. Milligram3. Kilogram4. Ounce

5. Pound6. Ton7. Liter8. Milliliter

Estimated Street Value

TO

TA

LS

CO

DE

SD

RU

GS

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

PR

OP

ER

TY

Serial Number

NameItem #Code Person Status Damage Property Type Quantity Brand Model Name/Number

Owner Applied Number Description (Size, Color, Caliber, Barrel Length, Etc. )

Value Value Recovered Date Recovered SCIC/NCIC

Activity Description Quantity Unit Estimated Street Value

Activity Description Quantity Unit Estimated Street Value

AD

MIN

IST

RA

TIV

E

ID. Number(s)/Locator code Unit

DateID. Number Routed To Referred To Assigned To

Officer(s) Reporting Date

By

of

PagePage

Officer Reviewing (If Applicable)

Signature of Officer Reviewing

Signature of Officer Reporting

9. Dose Unit/Item

__/__/____

08/28/2017

__/__/____

__/__/____

__/__/____

__/__/____

08/28/2017

08/28/2017

__/__/____

USA Rev. 01/21/2003

C O P

Y

Page 25: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Holmes Beach Police DepartmentFL0410400 20170719

1 1

DET

OGLINE

SGT.COPEMAN 307

322

Fa I RESPONDED TO A REPORT OF A BURGLARY PAST AT LISTED LOCATION. UPON ARRIVAL, I MET WITH THE

VICTIM, BOBBY MOORE, WHO INFORMED ME HE WAS LAST THERE ON 8/14/2017 AND LEFT AROUND 1500 HOURS. HE

SAID HE AND HIS WIFE CAME BACK YESTERDAY AROUND NOON AND FOUND HIS SHOTGUN HANGING IN THE MASTER

BATHROOM ON A HOOK INSTEAD OF IN AN ORANGE WATERPROOF CASE HE KEPT IT IN WHILE HE STORED IT IN THE

CLOSET. HE SAID THE CASE WAS USED FOR TRANSPORTING THE SHOTGUN, A MOSSBERG MODEL 510 WITH PISTOL GRIP,

WHILE ON ONE OF HIS BOATS. HE SAID IT DID NOT HIT HIM THAT HE WAS THE VICTIM OF A BURGLARY UNTIL HE

JUST WENT INTO THE GARAGE AND FOUND 18 REELS TAKEN OFF OF 18 FISHING POLES. HE SAID HE THEN STARTED

LOOKING AROUND AND FOUND HIS NEW SATELLITE PHONE MISSING FROM THE CLOSET, WHERE HE KEPT IT ABOVE WHERE

THE SHOTGUN WAS KEPT. HE SAID HE FOUND A SMALL RECTANGULAR WOODEN STOOL HE USED IN HIS BATHROOM

MISSING, ALSO.

BASED UPON THE VICTIM'S STATEMENTS, I DETERMINED THE SUSPECT(S) ARMED THEMSELVES WITH THE SHOTGUN

AT SOME POINT BUT DID NOT REMOVE IT FROM THE PREMISES. AN INITIAL SEARCH OF THE PERIMETER DID NOT

REVEAL A POINT OF ENTRY/EXIT BUT I EVENTUALLY FOUND PRY MARKS ON TOP OF THE BOLT FOR THE DOOR HANDLE

TO THE SIDE (WEST) GARAGE DOOR. THE DEADBOLT WOULD NOT ENGAGE DUE TO THE DOOR WARPING AND I COULD SEE

FRESH MARKS ON TOP OF THE DOOR HANDLE BOLT BETWEEN THE DOOR AND JAMB INDICATING SOMEONE USED A FLAT

AND SHARP INSTRUMENT, LIKE A SMALL POCKET KNIFE, TO REACH IN BEHIND THE BOLT TO POP THE DOOR OPEN.

THE VICTIM AND I THEN CHECKED HIS TWO BOATS AND WE FOUND ONE OF THEM HAD BEEN ENTERED. BOTH BOATS

WERE ON LIFTS OUT BACK ON THE CANAL AND I CONFIRMED ENTRY WAS MADE TO HIS 33 FT GRADY WHITE, MODEL 330

EXPRESS, FL2765PF, BECAUSE THE CABIN DOOR WAS OPEN AND WAS KEPT CLOSED. I ALSO NOTICED THE LADDER TO

THE RIGHT OF THE MOTORS, IF YOU WERE AT THE BACK OF THE BOAT, WAS DOWN AND THE VICTIM SAID IT WAS

USUALLY KEPT UP. WITH THAT, I DETERMINED IT WAS A STRONG POSSIBILITY THE SUSPECT(S) APPROACHED THE

RESIDENCE BY BOAT, AS THERE WAS NO REASON FOR THE LADDER TO HAVE BEEN PULLED DOWN UNLESS IT WAS

ENTERED FROM ANOTHER BOAT ON THE WATER. I THEN FOUND A POLE THAT HAD THE REEL STRIPPED OFF OF IT IN

THE CABIN, BRINGING THE TOTAL TO 19 REELS TAKEN FROM THE VICTIM.

I WAS UNABLE TO LOCATE ANY PHYSICAL EVIDENCE FROM THE RESIDENCE BUT DID OBTAIN 10 LATENT PRINT

CARDS FROM THE BOAT. I LATER PLACED THE LATENT PRINT CARDS INTO THE EVIDENCE BOX AT THE STATION. I

ALSO HAD DISPATCH OPERATOR #: 325 ENTER THE PHONE INTO THE FCIC/NCIC STOLEN FILES. I CHECKED THE PAWN

SHOP DATABASE FOR LOCAL AND SURROUNDING COUNTIES' PAWNS OF MULTIPLE REELS AND THE SATELLITE PHONE WITH

NEGATIVE RESULTS. THERE WERE NO OTHER LEADS TO FOLLOW UP ON NOR ANY OTHER PHYSICAL EVIDENCE TO

COLLECT.

NA

RR

AT

IVE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense

2. Arrest

Juvenile

Warn/Dismiss

1. Original

2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

08/28/2017

08/28/2017

__/__/____

__/__/____

USA Rev. 01/21/2003

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Page 26: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Holmes Beach Police Department

FL0410400

26

00

1529

1 1 1 0 0

STATE

JOSE PEREZ

5412 25TH ST. UNIT B 34207BRADENTON

LABORER

P625425874080

SHIRT AND JEANS

507 175

1529 1529 1539

1529 1529

29

20170721

MEXICO

OF FLORIDA

DRIVERS LICENSE

Tue Tue

Tue

1V 3

PEREZ-MARQUEZ JOSE ERNESTO1 2A

MW BRO BLK

FL

S S

LT MED M

FL

34 2B 90004 322CDRIVERS LIC

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

34217 W80

KING FISH

MAANTEE AVE. HOLMES BEACH700

0 0

I RAN TAG (0625TJ) THROUGH FCIC/NCIC. THE RETURN DISPLAYED THAT REGISTERED OWNER DID NOT HAVE AVALID LICENSE. I INITIATED TRAFFIC STOP AND WAS GIVEN CREDENTIALS EXCEPT A LICENSE. SUBJECT SAID HEDIDN'T HAVE A LICENSE AND HAS A LAWYER TO GET ONE. SUBJECT'S VEHICLE REGISTRATION HAS P625425874080 ASADMINISTRATIVE NUMBER. BUT, HOWEVER A D.A.V.I.D. QUERY STATED THAT HE HAS NUMBER (P620420874080) UNDERTHE SHORTENED NAME JOSE PEREZ; ASSIGNED TO HIM. THE HISTORY OF THAT STATED THAT SUBJECT HAS BEENPREVIOUSLY CITED FOR DWLS. SUMMONS ISSUED IN LIEU OF ARREST.

11

JASON HIGGINS

SGT.COPEMAN 307

331

1

EV

EN

TD

AT

AN

AR

RA

TIV

ES

US

PE

CT

00. N/A01. Gunshot02. Stabbed

CO

DE

SA

DM

A-Attempted

C-Committed

A-Attempted

C-Committed

Area

Type of Weapon

01. Residence Single

02. Apartment/Condo

03. Residence-Other

04. Hotel/Motel

Time (mil)

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance

9. Other

Zone

)

Agency Report Number

3. Misdemeanor

4. Traffic Misdemeanor

OFF/INC

# 2

OFF/INC

# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims

00. N/A01. Handgun

05. Knife/CuttingInstrument

06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - Other

Race

N - N/AM - MaleF - FemaleU - Unknown

Residence Type

0. N/A1. City2. County

Extent of InjuryResidence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

Residence Phone

Business Phone

Juvenile

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony

2. Traffic Felony To

Time (mil)

(-

Type

30. Other Mobile

99. Other

15. Industrial/Mfg.

16. Storage

17. Gov't/Public Bldg.

18. School/University

19. Jail/Prison

20. Religious Bldg.

21. Airport

22. Bus/Rail Terminal

23. Construction Site

24. Other Structure

25. Parking Lot/Garage

26. Highway/Roadway

27. Park/Woodlands/Field

28. Lake/Waterway

29. Motor Vehicle

10. Dept/Discount Store

11. Specialty Store

12. Drug Store/Hospital

13. Bank/Financial Inst.

14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

0. N/A

1. Occupied

E-EscapeeZ-Other

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied

3. Abandoned

05. Convenience Store

06. Gas Station

07. Liquor Sales

08. Bar/Nightclub

09. Supermarket

DateDay

0. N/A

1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

13. Drugs88. Unknown99. Other

Grid

Victim Type

0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex

I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl

Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

Susp. #

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

# Prem. Ent.

S-SuspectA-Arrestee

Dom. Violence

Dom. Violence

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

Age

Date of Birth Age

Date of Birth Age

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

V. TypeOFF/INC Indicator

If V/W Code isV, W or C

Fill in this Line

1.#12.#2

3.Both

OFF/INC Indicator

If V/W Code isV, W or C

Fill in this Line

1.#12.#2

3.Both

Person/Unit Notified

Case Status

Time

Routed To Referred

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

1. Original2. Supplement

Juvenilein Report

JuvenileWarn/Dismiss

1

__/__/____

08/29/2017

08/29/2017 08/29/2017

__/__/____

08/29/2017

__/__/____

11/08/1987

Signature of Officer Reporting

Signature of Officer Reviewing

Yes No

YYeess NNoo

12 NOFFENSE-INCIDENT REPORTGangRelated

C O P

Y

Page 27: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Holmes Beach Police Department

FL0410400

26

00

1549

01 01 01 00 00

CITY OF HOLMES BEACH

5801 MARINA DR HOLMES BEACH 34217

846 SW 31st TER 33991CAPE CORAL

W435778632130

510 160

1549 1549 1605

1545 1550

54

20170722

MD

TRAFFIC STOP

Tue Tue

Tue

2 NN 0 0 0 00 0000

1V 5

FL

WALTMAN ROBERT THOMAS1 2A

MW BRO BRO

FL

M S

LT THN

FL

34 2a 90004 322CDRIVERS LIC

708-5800941

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

239 321-0662

34217EAST BAY DR HOLMES BEACH3900

0 0

I STOPPED A BLUE KIA FL TAG 296KZP AFTER RANDOMLY RUNNING TAGS AND GETTING A HIT ON THE REGISTEREDOWNER, ROBERT WALTMAN, SHOWING A TOTAL OF 4 SUSPENSIONS ON HIS DRIVER LICENSE, 2 FOR DUI. I ISSUED UTCSUMMONS A2H5Y2E FOR DWLS W/ KNOWLEDGE AFTER HE CONFIRMED HE KNEW HIS DL WAS SUSPENDED. I TURNED SIGNEDCOURT COPY IN FOR RECORDS.

OGLINE

SGT.COPEMAN 307

322

1

EV

EN

TD

AT

AN

AR

RA

TIV

ES

US

PE

CT

00. N/A01. Gunshot02. Stabbed

CO

DE

SA

DM

A-Attempted

C-Committed

A-Attempted

C-Committed

Area

Type of Weapon

01. Residence Single

02. Apartment/Condo

03. Residence-Other

04. Hotel/Motel

Time (mil)

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance

9. Other

Zone

)

Agency Report Number

3. Misdemeanor

4. Traffic Misdemeanor

OFF/INC

# 2

OFF/INC

# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims

00. N/A01. Handgun

05. Knife/CuttingInstrument

06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - Other

Race

N - N/AM - MaleF - FemaleU - Unknown

Residence Type

0. N/A1. City2. County

Extent of InjuryResidence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

Residence Phone

Business Phone

Juvenile

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony

2. Traffic Felony To

Time (mil)

(-

Type

30. Other Mobile

99. Other

15. Industrial/Mfg.

16. Storage

17. Gov't/Public Bldg.

18. School/University

19. Jail/Prison

20. Religious Bldg.

21. Airport

22. Bus/Rail Terminal

23. Construction Site

24. Other Structure

25. Parking Lot/Garage

26. Highway/Roadway

27. Park/Woodlands/Field

28. Lake/Waterway

29. Motor Vehicle

10. Dept/Discount Store

11. Specialty Store

12. Drug Store/Hospital

13. Bank/Financial Inst.

14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

0. N/A

1. Occupied

E-EscapeeZ-Other

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied

3. Abandoned

05. Convenience Store

06. Gas Station

07. Liquor Sales

08. Bar/Nightclub

09. Supermarket

DateDay

0. N/A

1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

13. Drugs88. Unknown99. Other

Grid

Victim Type

0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex

I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl

Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

Susp. #

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

# Prem. Ent.

S-SuspectA-Arrestee

Dom. Violence

Dom. Violence

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

Age

Date of Birth Age

Date of Birth Age

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

V. TypeOFF/INC Indicator

If V/W Code isV, W or C

Fill in this Line

1.#12.#2

3.Both

OFF/INC Indicator

If V/W Code isV, W or C

Fill in this Line

1.#12.#2

3.Both

Person/Unit Notified

Case Status

Time

Routed To Referred

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

1. Original2. Supplement

Juvenilein Report

JuvenileWarn/Dismiss

1

__/__/____

08/29/2017

08/29/2017 08/29/2017

__/__/____

08/29/2017

__/__/____

06/13/1963

Signature of Officer Reporting

Signature of Officer Reviewing

Yes No

YYeess NNoo

12 NOFFENSE-INCIDENT REPORTGangRelated

C O P

Y

Page 28: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

502FW 1904/06/1998

FL0410400

26

00

0900

01 01 01 00 00

WOODARD

707 63RD AVE DR W 34207BRADENTON

W363733986260

Holmes Beach Police Department

0900 0900 0914

20170723

RHIANNON MARIE

DRIVERS LICENSE

01

Thu

01 STATE OF FLORIDA

2 NN

V 0

2A

0 0 0 00 0000

FL

LT MED

FL

01

PATROL

1 ACA

J. PIERCE

SGT. M. PILATO 306

201 2 9000324CDRIVERS LIC

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

___ ___-____

34217GULF DR HOLMES BEACH6400

0

4

1

309

1

N2 1

00. N/A

01. Gunshot

02. Stabbed

OFF/INC Indicator

EV

EN

TD

AT

AN

AR

RA

TIV

ES

US

PE

CT

CO

DE

SA

DM

A-AttemptedC-Committed

A-AttemptedC-Committed

Area

Type of Weapon

01. Residence Single02. Apartment/Condo03. Residence-Other04. Hotel/Motel

Time (mil)

GangRelated

Time Dispatched (mil)

Primary Offense Description

21. Employer

22. Landlord/Tenant

23. Acquaintance

99. Other Known

5. Ordinance9. Other

Zone

)

Agency Report Number

3. Misdemeanor4. Traffic Misdemeanor

OFF/INC# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims

00. N/A01. Handgun

05. Knife/CuttingInstrument

06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - Victim

W - Witness

C - Reporting Person

O - Other

Race

N - N/A

M - Male

F - Female

U - Unknown

Residence Type

0. N/A

1. City

2. County

Extent of InjuryResidence Status

03. Laceration

04. Unconscious

05. Poss. Broken Bones

06. Poss. Internal Injury

Victim Relationship To Offender07. Loss of Teeth

08. Burns

09. Abrasions/Bruises

99. Other

06. Parent

07. Brother/Sister

08. Child

09. Step-Parent

10. Step-Child

11. In-Law

12. Other Family

13. Student

Residence Phone

Business Phone

Juvenille

Occupation

Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony2. Traffic Felony To

Time (mil)

(-

Type

15. Industrial/Mfg.16. Storage17. Gov't/Public Bldg.18. School/University19. Jail/Prison

20. Religious Bldg.21. Airport22. Bus/Rail Terminal23. Construction Site24. Other Structure

25. Parking Lot/Garage26. Highway/Roadway27. Park/Woodlands/Field28. Lake/Waterway29. Motor Vehicle

10. Dept/Discount Store11. Specialty Store12. Drug Store/Hospital13. Bank/Financial Inst.14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

OFFENSE-INCIDENT REPORT

0. N/A1. Occupied

E-EscapeeM-Missing

From

Date of Supplement

- (

17. Friend

18. Neighbor

19. Sitter/Day Care

20. Employee

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied3. Abandoned

05. Convenience Store06. Gas Station07. Liquor Sales08. Bar/Nightclub09. Supermarket

DateDay

0. N/A1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair Color

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

13. Drugs88. Unknown99. Other

Grid

Victim Type0. N/A

1. Juvenile

2. L.E. Officer

3. Adult

4. Business

5. Government

6. Church

9. Other

Sex

I - American Indian

O - Oriental/Asian

U - Unknown

N - N/A

W - White

B - Black

3. Florida

4. Out-of-State

0. N/A

1. Full Year

2. Part Year

3. Non-Resident

0. None

1. Minor

2. Serious

3. Fatal

14. Teacher

15. Child of Boy/Girl

Friend

16. Boy/Girl Friend

03. Spouse

04. Ex-Spouse

05. Co-Habitant

00. N/A

01. Undetermined

02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

# Prem. Ent.

S-SuspectA-Arrestee

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

If V/W Code isV, W or C

Fill in this LineOFF/INC Indicator

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

Dom. Violence

Dom. Violence

1.#12.#2

3.Both

1.#12.#2

3.Both

Date of Birth Age

Date of Birth Age

If V/W Code isV, W or C

Fill in this Line

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

OFF/INC# 2

R-Rec. MissingZ-other

Person/Unit Notified

Case Status

Time

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type2. Arrest on Primary Offense

Secondary Offense Without Prosecution3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

By DateAssigned To

30. Other Mobile99. Other

Susp.#

JuvenileWarn/Dismiss:

1. Original2. Supplement:

Juvenilein Report:

__/__/____

08/31/2017

08/31/2017

__/__/____

USA Rev. 01/23/2003

Thu Thu08/31/2017 08/31/2017

Sex Date of BirthRace Age

08/31/2017

Yes No

YYeess NNoo

0

Signature of Officer Reporting

Signature of Officer Reviewing

C O P

Y

Page 29: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Holmes Beach Police Department

DRIVERS LICENSE

2 1

01

PATROL

1 ACA

J. PIERCE

SGT. M. PILATO 306

309

ON 08-31-17 WHILE ON ROUTINE PATROL I OBSERVED A WHITE HONDA BEARING FL TAG# EGWA21 TRAVELING NORTH ON

GULF DR. UPON RUNNING THE TAG THROUGH FCIC/NCIC THE DRIVER/REGISTERED OWNER (RHIANNON MARIE WOODARD)

HAD A SUSPENDED LICENSE AS OF 08/24/2017 FR-SUSP NON-JUDGEMENT SUSPENSION. I CONDUCTED A TRAFFIC STOP

ON THE VEHICLE AND SPOKE WITH THE DRIVER (RHIANNON MARIE WOODARD). I ADVISED HER THAT HER DRIVERS

LICENSE HAD A CURRENT SUSPENSION ON IT. SHE ADVISED SHE WAS HAVING A PROBLEM WITH HER INSURANCE AND

THAT IT HAD LAPSED. I ISSUED WOODARD A SUMMONS FOR DRIVING ON A SUSPENDED LICENSE (FR SUSPENSION).

CITATION:A2H5Y3E

NA

RR

AT

IVE

Original Date Reported

NARRATIVE CONTINUATION

Case ReferenceAD

M

Date of Supplement Agency ORI Number

1. Offense

2. Arrest

Juvenile

Warn/Dismiss

1. Original

2. Supplement

Agency Report Number

Case Status

Routed To Referred To

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator CodeReport Contains

Arrest Number

__/__/____

08/31/2017

08/31/2017

__/__/____

08/31/2017

USA Rev. 01/23/2003

20170723FL0410400

Signature of Officer Reviewing

Signature of Officer Reporting

C O P

Y

Page 30: OFFENSE-INCIDENT REPORT N 1 M Holmes Beach …holmesbeachfl.org/Cities/COHB/documents/20170831.pdf · 6700 palm drive holmes beach 0 0 i ran tag (eefr40)that was affixed to lincoln.

Holmes Beach Police Department

FL0410400

26

00

1001

01 01 01 00 00

STATE OF FLORIDA

604 58TH AVE DRIVE EAST 34203BRADENTON

CLEANER

NONE

506

1001 1001 1050

1000 1001

38

20170724

UNKNOWN

CRIM TRAFFIC

Thu Thu

Thu

2 NN 0 0 0 00 0000

1V 5

CONTRERAS MARIA1 2A

FW

FL

FL

03 1 90004 322CDRIVERS LIC

___-_______

___-__-____

___ ___-____

___-_______

___ ___-____

___-_______

941 580-4402

34217MARINA DR HOLMES BEACH8100

0 1

WHILE ON PATROL, I OBSERVED THE VEHICLE DRIVING NORTH ON GULF DR. I RAN THE PLATE AND THE REGISTEREDOWNER. UPON GETTING THE RETURN, THE REGISTERED OWNER DID NOT HAVE A DRIVERS LICENSE. ON ANINVESTIGATIVE STOP, I MET WITH THE DEFENDANT WHO STATED THAT SHE DID NOT HAVE A DRIVERS LICENSE. UPONGETTING AN INTERPRETER TO COMMUNICATE, SHE ADVISED THAT SHE HAS NEVER HAD A DRIVERS LICENSE. SHE WASISSUED A NOTICE TO APPEAR FOR THE VIOLATION AND SHE DID NOT HAVE A VALID INSURANCE CARD AND WAS ISSUEDA UTC. (A2H5Y5E)SHE WAS RELEASED ON SCENE AND HER BOSS PARKED HER VEHICLE IN A PARKING LOT. NFI

01

PATROL

1 ACA

SGT. M. PILATO

SGT. M. PILATO 306

306

1

EV

EN

TD

AT

AN

AR

RA

TIV

ES

US

PE

CT

00. N/A01. Gunshot02. Stabbed

CO

DE

SA

DM

A-Attempted

C-Committed

A-Attempted

C-Committed

Area

Type of Weapon

01. Residence Single

02. Apartment/Condo

03. Residence-Other

04. Hotel/Motel

Time (mil)

Time Dispatched (mil)

Primary Offense Description

21. Employer22. Landlord/Tenant23. Acquaintance99. Other Known

5. Ordinance

9. Other

Zone

)

Agency Report Number

3. Misdemeanor

4. Traffic Misdemeanor

OFF/INC

# 2

OFF/INC

# 1

Business Name/Area Identifier

District

NCIC/UCR Code

2. No

Location Type

V/W Code

# Victims

00. N/A01. Handgun

05. Knife/CuttingInstrument

06. Blunt Object

07. Hands/Fist/Feet08. Poison09. Explosives

10. Fire/Incendiary11. Threat/Intimidation12. Simulated Weapon

V - VictimW - WitnessC - Reporting Person

O - Other

Race

N - N/AM - MaleF - FemaleU - Unknown

Residence Type

0. N/A1. City2. County

Extent of InjuryResidence Status

03. Laceration04. Unconscious05. Poss. Broken Bones06. Poss. Internal Injury

Victim Relationship To Offender07. Loss of Teeth08. Burns09. Abrasions/Bruises99. Other

06. Parent07. Brother/Sister08. Child09. Step-Parent

10. Step-Child11. In-Law12. Other Family13. Student

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

Residence Phone

Business Phone

Juvenile

Occupation

Sex Date of Birth Height Weight Eye Color Hair Length Hair Style

Nickname/Street Name Place of Birth

Social Security Number

SCIC/NCIC

Employer/School

Teeth Speech/Voice Special Identifiers

Original DayReported

Date Time (mil) Time Arrived (mil) Time Completed (mil)

1. Felony

2. Traffic Felony To

Time (mil)

(-

Type

30. Other Mobile

99. Other

15. Industrial/Mfg.

16. Storage

17. Gov't/Public Bldg.

18. School/University

19. Jail/Prison

20. Religious Bldg.

21. Airport

22. Bus/Rail Terminal

23. Construction Site

24. Other Structure

25. Parking Lot/Garage

26. Highway/Roadway

27. Park/Woodlands/Field

28. Lake/Waterway

29. Motor Vehicle

10. Dept/Discount Store

11. Specialty Store

12. Drug Store/Hospital

13. Bank/Financial Inst.

14. Commercial/Office Bldg.

Suspect Code

Incident Location (Street Number, Street, Apt,)

Scars/Marks/Tatoos (Location/Describe)

0. N/A

1. Occupied

E-EscapeeZ-Other

From

Date of Supplement

- (

17. Friend18. Neighbor19. Sitter/Day Care20. Employee

V/W Code # Name (Last, First, Middle or Business) Residence Phone

Business Phone

Race Sex Injury Type(s) Relationship Ethnicity Will Victim prefer charge?

Synopsis of Involvement

V. Type

OFF/INC Indicator

OBTS Number (Arrested)Other I.D. NumberImmigration and Naturalization Number

Incident Type Incident: Day Date

2. Unoccupied

3. Abandoned

05. Convenience Store

06. Gas Station

07. Liquor Sales

08. Bar/Nightclub

09. Supermarket

DateDay

0. N/A

1. Yes

Forced Entry Occupancy

Statute Violation Number - Chapter, Section, SubDescriptionType

Hair ColorRace

Facial HairBuildComplexion

Driver's License Number/State

Address

Code

Maiden Name

Name (Last, First, Middle)

Extent of InjuryRes. StatusRes. Type

ZipStateCity

Extent of InjuryRes. StatusRes. Type

ZipStateCity

13. Drugs88. Unknown99. Other

Grid

Victim Type

0. N/A1. Juvenile2. L.E. Officer3. Adult

4. Business5. Government6. Church9. Other

Sex

I - American IndianO - Oriental/AsianU - Unknown

N - N/AW - WhiteB - Black

3. Florida4. Out-of-State

0. N/A1. Full Year2. Part Year3. Non-Resident

0. None1. Minor2. Serious3. Fatal

14. Teacher15. Child of Boy/Girl

Friend16. Boy/Girl Friend

03. Spouse04. Ex-Spouse05. Co-Habitant

00. N/A01. Undetermined02. Stranger

Injury Type

Clothing (Describe)

ZipStateCity

02. Rifle03. Shotgun04. Firearm

Susp. #

VIC

TIM

/W

ITN

ES

SV

ICT

IM/W

ITN

ES

S

# Prem. Ent.

S-SuspectA-Arrestee

Dom. Violence

Dom. Violence

ZipCity

# OFF/INC. # Offenders # Veh. Stolen

1.#12.#2

3.Both

)

Age

Date of Birth Age

Date of Birth Age

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Address (Street, Apt. Number)

Other Contact Info. (Time Available, Interpreter, etc.)

Last Known Address (Street, Apt. Number)

V. TypeOFF/INC Indicator

If V/W Code isV, W or C

Fill in this Line

1.#12.#2

3.Both

OFF/INC Indicator

If V/W Code isV, W or C

Fill in this Line

1.#12.#2

3.Both

Person/Unit Notified

Case Status

Time

Routed To Referred

Related Report Number(s)

Unit

of

Page

Number ArrestedClearance Type

Exception Type 2. Arrest on Primary OffenseSecondary Offense Without Prosecution

3. Death of Offender4. V / W Refused to Cooperate

3.Unfounded

Page

Date

5. Prosecution Declined6. Juvenile/No Custody1.Extradition Declined

1.Arrest2.Exceptional

Jail Number

OBTS Number

Date Cleared

ByAssigned To

AD

MIN

IST

RA

TIV

E

A-AdultJ-Juvenile

Date

Name of Officer Reporting

Officer Reviewing (If Applicable) I.D. Number

I.D. Number/Locator Code

1. Original2. Supplement

Juvenilein Report

JuvenileWarn/Dismiss

1

__/__/____

08/31/2017

08/31/2017 08/31/2017

08/31/2017

08/31/2017

__/__/____

06/09/1979

Signature of Officer Reporting

Signature of Officer Reviewing

Yes No

YYeess NNoo

12 NOFFENSE-INCIDENT REPORTGangRelated

C O P

Y