Non-Felony/Non-Workable Minor Incident Report [South Gate PD] TYPE* Theft Under $950 Auto Tampering Malicious Mischief Insurance Report Other Other: Specify* LOCATION OF OCCURRENCEFirm Name, If Any AREA OCCURRED ON/OR BETWEENDATE DAY TIME ANDDATE DAY TIME DATE REPORTED TIME REPORTED ISSUING OFFICER VICTIM/OWNERFIRST NAME MIDDLE NAME LAST NAME RACE SEX BIRTHDATE(MO/DAY/YEAR) RESIDENCE: STREET ADDRESS CITY STATE ZIP PRIMARY PHONE NUMBERBUSINESS ADDRESS OR SCHOOL ATTENDED: STREET ADDRESS CITY STATE ZIP BUSINESS OR SECONDARY PHONE NOSUSPECT INFORMATIONNOTE: IF YOU KNOW WHO IS RESPONSIBLE FOR THIS CRIME, DO NOT FILL OUT THIS FORM!! PLEASE RE-CONTACT THE POLICE DEPARTMENT (323)563-5400 AND ASK FOR AN OFFICERRACE SEX AGE PHYSICAL DESCRIPTION METHOD, TOOLS, WEAPON USED IF VEHICLE INVOLVED: SUSPECT’S VEHICLE VICTIM’S VEHICLE YEAR MAKE MODEL VEHICLE COLOR LICENSE PLATE STATE Give a brief summary of the incident below:PropertyIT IS A MISDEMEANOR TO MAKE A FALSE REPORT OF A CRIME (Sec. 148.5 CA Penal Code)DESCRIBE WHAT WAS Stolen Lost Damaged Article How Many Make/Model Serial # Color $ Value Article How Many Make/Model Serial # Color $ Value Article How Many Make/Model Serial # Color $ Value Article How Many Make/Model Serial # Color $ Value Article How Many Make/Model Serial # Color $ Value Article How Many Make/Model Serial # Color $ Value Article How Many Make/Model Serial # Color $ Value Article How Many Make/Model Serial # Color $ Value Article How Many Make/Model Serial # Color $ Value Article How Many Make/Model Serial # Color $ Value Article How Many Make/Model Serial # Color $ Value Article How Many Make/Model Serial # Color $ Value Enter your email address for a copy of this form
