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ARREST / NOTICE TO APPEAR 1 Arest 9 Request! for Warrant Juvenile Referral Report 2NTA 4 Request for Capia Agency Name Agency sO PALM BEACH POLICE DEPARTMENT Sea | Misdemeanor OS. Ordinance He Seized O 4. Traffic Mesdemeano O86 Other Parent Name (Last) {First} Ey Ea oman ‘Ackirées (Steel, Api. Number} : (City) or CF) defendant's parents. The chuid and / or parent was loki 3. Se aSes Misra ot es coeie meee OC _No: (Reason Amount / Unit UNSEr. ae a : aL? oye ON eat a eR ERED ce ES SS ee seouacaacn in Court (0 Instructian No. 2 ‘You need not appear in Gourt but must comply with instructions on Reverse Side HAT BHOOTO | WILLFULLY FAILTO ARREST SHALL BE ISSUED Name Verification (Primed by Arestee) (PRINT) a ; 2 i > pom ‘pise a aS at 6 mee. <a ions Sal DISTRIBUTION: WHITE — COURTCOPY GREEN — STATEATTORNEY YELLOW — AGENCY PINK — JAIL «= GOLD - DEFENDANT (N.T.A's GNLY) 07/26/17 Page 75 of 95 Public Records Request No.: 17-295 a DOJ-OGR-00031072