Non-Felony/Non-Workable Minor Incident Report [South Gate PD] TYPE* Theft Under $950 Auto Tampering Malicious Mischief Insurance Report Other Other: Specify*LOCATION OF OCCURRENCEFirm Name, If AnyAREAOCCURRED ON/OR BETWEENDATEDAYTIMEANDDATEDAYTIMEDATE REPORTEDTIME REPORTEDISSUING OFFICERVICTIM/OWNERFIRST NAMEMIDDLE NAMELAST NAMERACESEXBIRTHDATE(MO/DAY/YEAR)RESIDENCE: STREET ADDRESSCITYSTATEZIPPRIMARY PHONE NUMBERBUSINESS ADDRESS OR SCHOOL ATTENDED: STREET ADDRESSCITYSTATEZIPBUSINESS OR SECONDARY PHONE NOSUSPECT INFORMATIONNOTE: IF YOU KNOW WHO IS RESPONSIBLE FOR THIS CRIME, DO NOT FILL OUT THIS FORM!! PLEASE RE-CONTACT THE POLICE DEPARTMENT (323)563-5400 AND ASK FOR AN OFFICERRACESEXAGEPHYSICAL DESCRIPTIONMETHOD, TOOLS, WEAPON USEDIF VEHICLE INVOLVED: SUSPECT’S VEHICLE VICTIM’S VEHICLE YEARMAKEMODELVEHICLE COLORLICENSE PLATESTATEGive a brief summary of the incident below:PropertyIT IS A MISDEMEANOR TO MAKE A FALSE REPORT OF A CRIME (Sec. 148.5 CA Penal Code)DESCRIBE WHAT WAS Stolen Lost Damaged ArticleHow ManyMake/ModelSerial #Color$ ValueArticleHow ManyMake/ModelSerial #Color$ ValueArticleHow ManyMake/ModelSerial #Color$ ValueArticleHow ManyMake/ModelSerial #Color$ ValueArticleHow ManyMake/ModelSerial #Color$ ValueArticleHow ManyMake/ModelSerial #Color$ ValueArticleHow ManyMake/ModelSerial #Color$ ValueArticleHow ManyMake/ModelSerial #Color$ ValueArticleHow ManyMake/ModelSerial #Color$ ValueArticleHow ManyMake/ModelSerial #Color$ ValueArticleHow ManyMake/ModelSerial #Color$ ValueArticleHow ManyMake/ModelSerial #Color$ ValueEnter your email address for a copy of this form
