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OBTS Number ARREST / NOTICE TO APPEAR 1 Arrest 3 Request for Warrant Juvenile Juvenile Referral Report 2NTA 4 Request for Capia ira ro, 5, 0 aa me 0,90 vA BEACH POLICE DEPARTMENT falchecs as a Inany Felony Misdemeanor ae if ol Seized Multiple Ss : Traffic sb Traffic Miscemeanor Enter Type paeence fer en e | BEE. Bele Way Plu Bea i. F A ed] Name (Last, First, Middle) lias (Name, DOB, Soc. Sec. #, Etc.) ae ae JErmeey ec Race ; : Sex Date of Birth Height Weight Eye Color Hair Color Complexion uid W - Whit 1- A Indi co ye f-meneay WM [Ort 2,0,5,3 Blog | Goby MeD Scars, Marks, Tattoos, Unique Physica! Features (Location, Typa, Description) nn iad Ce ‘es cohol Influence g EE [a O Local Address (Stree ‘- ‘ep Vr ¥ (St (Zip) Phone Ay EDC eo Pe ‘ ae t, Apt. Num ay) ; oe se O32: HI 7 re = is Se rere iy MT ae) ee Ge>7 Wibiso) Ae _ Ny. ate), rs re (coz |i NEST —_ A, ae SEW Yor .]Go-Defendant Name irst, Middle Sex Date of Birth (11. Arrested a ny O12. At Large o4 Misdemeanor BEE ae Co-Defendant Name am First, Middle) Race Date of Birth HS L}3. 2 Atl too O4. Seenaarct O5. Juvenile Name (Last) (First) (Middle) inca Phone Lapa of Cuntodion Ot Addréss (Street, Apt. Number) i (State) The above address was provided by [1] defendant and / or 1) defendant's parents. The child and / or parent was told School Attended to keep the Juvenile cant Clerk's Office (Phone 355-2526) a be td change of address. QO Yes, by: (Name jo: (Reason Description of Property Value of Property R. DEFENDANT : muggle Dispense/ M. Manufacture/ zZ. Other f Dru biturate allucinogen P. Paraphernalia/ . Unknown VA my D.D — "Distribute Produce/ iN, alad C Coane M : ee Pays ment Z. Other P. Possess T. Traffic Sie A. Amphetamine E. Heroin Opium/Deri S. Synthetic harge o pO mestic a KS, olatios We Violation of ORD # Mo _ ANL U ce = S w/MIN6 | S[ouaae Acti Drug Ty Amount / Unit Offense # es sie / as aoe OS ars a ouNts vlog Syay folation ia ‘—— of ORD # ae Ni ole ere ul CC Hole oe uw Charge Description Statute Violation Number Violation of ORD # ve ve | CJ Instruction No. 1 Location (Court, Room Number, Address) Pa | Mandatory Appearance in Court © Instruction No. 2 You need not appear in Court but must Court Date and Time comply with instructions on Reverse Side. Month Year Time AM. BAK | AGREE TO APPEAR AT THE TIME AND PLACE DESIGNATED TO ANSWER THE OFFENSE CHARGED OR TO PAY THE FINE SUBSCRIBED. | UNDERSTAND THAT SHOULD | WILLFULLY FAIL TO APPEAR BEFORE THE COURT AS REQUIRED BY THIS NOTICE TO APPEAR, THAT | MAY BE HELD IN CONTEMPT OF COURT AND A WARRANT FOR MY ARREST SHALL BE ISSUED. io a Signature of Defendant (or Juvenile and Parent / Custodig Date Signed oe te HOLD for other Agency Signature of Ares i Olid in EE oly (C0 Dangerous CO Resisted Arrest Name of Arrestin; a Ti —— (PRINT) DO Suicidal FE Onto Vet. Soe Peavey “Ais PAGE | Witness here if subject signed with an “X". OF DISTRIBUTION: WHITE — COURTCOPY GREEN — STATEATTORNEY YELLOW — AGENCY PINK — JAIL. © GOLD - DEFENDANT (N.T.A’s ONLY) 07/26/17 Page 2060 Public Records Request No.: 17-295 Name Verification (Printed by Arrestee) DOJ-OGR-00032373