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Jate 4/20/06 “ime: 13:02:26 ‘ase No. . ‘ itreet Number MEY «x irth Date/Age ‘ccupation . ome Phone No. ex ai & eight os ther Phone “Nbr: ase Number mployer Name ddress ity/State/Zip hone Number kkkkkkkke O T HER ase Number zreet Number bey). « irth Date/Age tcupation ome Phone No. >, ne sight .. cher Phone Nor: ise Number ldress A ty/State/Zip ione Number kkkkkxke O THER se Number reet Number ty. ren Date/Age cupation me Phone No. x ight << ws : her Phone Nbr: kkkkkEkKe O THER se Number reet Number Cr te aes OE rth Date/Age cupation ne Phone No. K 07/26/17 PALM BEACH POLICE DEPARTMENT Page: 10 Incident Report Program: CMS301L 1-05-000368 (Continued) 0/00/0000 O Employer? FAMILY THERAPIST Oper Lic No. 561/000-0000 Race . - . . : White Female Heignt:. «. » « 4.8 0 Person Type OTHER PERSON 561/000-0000 *** EMPLOYER INFORMATION®* ** 1-05-000368 PBC DIVISON OF YOUTH AFFAIRS 4200 N AUSTRALIAN AV WEST PALM BEACH, FL 33407 561/840-4540 PERSON 1-05-000368 INFORM m TION - Last Name # G6 KKKKKKEKE Y¥ a. Employer? : Oper Lic No. : 561/383-6810 Race . «a # White Male Height .«. .: @ 0 Person Type OTHER PERSON ***EMPLOYER INFORMATION*** 1-05-000368 Employer Name 4900 SUMMIT BV WEST PALM BEACH, FL 33415 SUMMIT CHRISTIAN SCHOOL PERS ON 1-05-000368 INFORM a TION -—- #£ 7 #RKKK KKK WEST PALM BEACH, FL 33412 0/00/0000 Oo Employer? . . Oper Lic No. Race ao White Male Height ....: 0 0 Person Type OTHER PERSON PERSON 1-05-000368 201 CYPRESS TR WEST PALM BEACH, FL 33411 INFORMATION - # 8 KkkkkkKKEK Last Name HERNANDEZ, JEANNIE 0/00/0000 0 Employer? Oper Lic No. 561/667-9764 Race a: Female Height ..+«.. #6 Page 2533 Public Records Request No.: 17-295 DOJ-OGR- 00032846