DOJ-OGR-00032372.jpg

St OZER, F124) OBTS Numier ars NOTICE TO APPEAR 1. Am _/ 3. Request for Warrant Juvenile Juvenile Referral Report 2.N.TA. 4. Request for Capias ] Sea ORI Number Agency Name f Agency Report Numbe rio, 5,0, 0, 0, 0, 0| PALM BEACH COUNTY SHERIFF'S OFFICE ype: bel C] 3. Misde C's. orc if Weapon Seized Multiple q 2. Tratlie Felony LJ 4. neers CO) ; pili. Ea ID sae Arrest re Name of ae p ¢: Location of Offense (Business Name, im. Date af arrest ££ = =e Booking Date Booking Time | Jail Date. Jail Time Location of Vehicle | 2,3,0,6| O w = ij <= c = 2 Zz = a] < Name (Last, First, gp Alias (Name, DOB, Soc. Sec. #, Etc.) ee Sy ae ie - a 5 we | Weight * er Hair Color Complexion Build : e - American indian B- Black —_O- Oriental/Asian Z,0 Pg BO Ole FG os Scars, Marks, Tatoos, bitiuay am AE, A (Location, cata Description) = 14 Reli ugion — Indication of: a) Wi yn & Alcohol Influence = (240) - | Drug steel 5 (Zip) s pei lence Type Me 4 1. City lorida é Be, rC 32480 eae ~ SHb 2. County 4. Out of State w (City) i Phone ary a £ w 3 oh Buckler HTL SH ig EE ae De Business = oy ae (City) le (Zip Phone ee ig K £7 oak p) | D/L Number, State Soc. ee = - Place of Birth (City, DY Citizenship = Yen fos AY) usr _ | Co-Defendant Name (Last, First, Middia) Date of Birth 5 1, Arrested ( 3. Felony bry 0 2. At Large 0 4, Misdemeanor 5 C 5. Juvenile © [Co-Defendant Name mee aa First, Middle) pie EE Date of Birth = 1 Arrested 3. Felony = 5 2. At Large = 4. Misdemeanor Cc 5. Juvenile ne ER ania Parent Name (Last) (Middle) Residence Phone 22’ Legal Custodian i Other: = b ste =e ae age 7 oe ny a Notified by: (Name) Time Juvenile Disposition wi \i4 Handled/Processed within 2. TOT HRS/DYS = g Dept. and Released. 3. Incarcerated Wi] Released To: (Name) | ——“Fe ‘ | Date Time = i “ ‘ 5 F The above address ses provided by defendant_ and/or () defendant's parents: The child and/or parent was told Schoo! Attended Grade to keep the Juvenile oun Clerk's Office (Phone 355-2526) informed of any change of address. LD Yes, by: (Name) (3 No: (Reason) . | Property Crime? Description of Property 2 Vaiue of Property oO Yes [No ee R. Smuggie K. Dispense/ M. Manutacture/ Z. Other NMA Type 8. Barbiturate H. Hallucinogen 'P. Paraphernalia) U. Unknown D. Deliver Distribute Produce/ C. Cocaine M. Marijuana eaupert Z. Other E. Use Cultivate mphetamine E_ Heroin O. Opium/Deriv. S. Synthetic Charge a. uns Domestic. “Sane yh. Number G Violation of ORD # Ww Ni olenic gn @| Fer y © ofr cited re fF yf tatioe’ coe [eases 0,767 A(P(O,.GF $ | Drug Activity] Drug 2 Amount / Unit Offense # Warrant / Capia ee me rz ype int / Uni lense st iS ca oem 5 4/ ee LOO r, | Charge Description Counts 7 ete =e Violation ie Violation of ORD # w jolence oO] OY ON < é ca ae = uf ee Charge Description ounts Domestic | Statute Violation Number vonter wo ORD # w ine re 4 rs) Charge Description Counts Domestic | Statute Violation Number Violation of ORD # w be iagir rd 3 ay — ie peer és) Location (Court, Room Number, Address) Court Date and Time Month | AGREE TO APPEAR AT THE TIME AND PLACE DESIGNATED TO ANSWER THE OFFENSE CHARGED OA 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 NOTICE TO APPEAR Signature of Defendant (or Juvenile and Parent’ Custodian) HOLD for other Agency Signature of Arresting Otficer Name: x Cas einen C) Dangerous LD Resisted Arrest Name of Arresting Officer (Print) LD. # CJ Suicigal 0 other: 07/26/17 - ee) Tageporoe Ogee Bes PEE Redeeppe_ “een DISTRIBUTION: WHITE-COURTCOPY GREEN-STATEATTORNEY YELLOW-AGENCY PINK-AGENCY GOLD - DEFENDANT (N.TA.'s ONLY) PBSO #148 REV. 6/97 $ Date Signed Name Verification (Printed by Arrestee) DOJ-OGR- 00032372