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Case 18-2868, Document 283, 08/09/2019, 2628241, Page605 of 883 Date: '7/25/06 PALM BEACH POLICE DEPARTMENT Page: ) Time: 8:47:53 Incident Report Program: CMS30iL Case No. . . . : 1-05-000368 (Continued) Can Identify . : Victim Sobriety: Injury Extent : Injury Type 1: Injury Type 2 : Hospital ID . : Med Treatment : Phys First Name: Phys Last Name tkKeeKEEEE OTHER PERSON INFORMA - re ae Case Number . : 1-05-000368 Last Name .. ha | Street Number : i City .. - : WEST PALM BEACH, FL 33411 Birth Date/age : :- Employer? Occupation . . : STUDENT Oper Lic No. Home Phone No. : Race... . . : White Sex ... . . : remale Height ....: 0 Weight ... : 0 Person Type . : OTHER PERSON Other Phone Nbr: teeeKEEEe OTHER PERSON INFORMATION - # Q #ktkteeEE Case Number . : 1-05-000368 Last Name . . : MARCINKOVA, NADA i Street Number : 358 EL BRILLO WY City... 3 aia : FL 000033480 { Birth Date/Age 2 19 Employer? ..: | Occupation . . : Oper Lic No. . | Home Phone No. Race... . . : White j Sex .... . : Female Height ... . : 510 | Weight ....: 0 Person Type . : OTHER PERSON | Other Phone Nbr: | ReKKRKEKKE OT HER PERSON INFORMATION - # 3 *ketkkKKEX Case Number . : 1-05-000368 Last Name .. FY | Street Number : ; | City .. . . :_ROYAL PALM BEACH, FL 33411 | Birth Date/Age : a = Employer? ..: i Occupation. . : Oper Lic No. . : | Home Phone No. : (iy Race i White i Sex ... ... : Female Height ...-.: 0 Weight 0 Person Type . : OTHER PERSON Other Phone Nbr: ReKKKKkKEE OT HER PERSON INFORMA - KKKKKKKEKK Case Number . : 1-05-000368 Last Name . . Street Number : City .. 7 Birth Date/Age : 37 Employer? .. : Occupation Oper Lic No. Home Phone No. : Race : White Sex ..... : Male Height ....: 0 Weight ...: :0 Person Type .. : OTHER PERSON Other Phone Nbr: RREKKKKKE OT HER PERSON TNF ORMA TION — 35 thkenenee | Case Number . : 1-05-000368 Last Name GIUFFRE005622 CONFIDENTIAL