*

~";;:rncel~
King County Sheriff
~ ~ - - 0 7 ~ rDis1ricl
'1 '11
g.
~ 1--_---n=~~~~r___.~V"~___,;;.:==_==ln-c-id-e-n-t-R-e-p-o-rt----_+='l.:;.::'1..~L.=----=E=----=0=-.L....:L=---_Lf....!..-l
~
0
'. 'OIi:tim Iolfow-up left by OtrIC8l
Repoftedon

Month

Day

Y,e:

TIme

DOW

lypeOfIncid8nt

UNINCDRP.KINGCOUNTY

oz I1-----t0;;'!>~\~OMitt;aHi
~,(J11i5W~::;.f)-f,WF.;-'1':':'iii0i;i~~IfM7:iti""iinorit~I\J~V~~~.s~'-=.l..::.cr!..:...-!-.M1~IO:..!..:rJ=---_-l.....!:r:t=:;C~rTY:;:0F~S~f.i\:"'U~~K=:=:~-l
Month Day Year DOW
Tune
liOn 01 Incident
DE
Occurredon O~ \0
" Wf,b 1C\5'Lf rs- I'J/& IJ.-r MU£ MMt-1<.Ltt. L51,4i4' CEf\lJ~I)
Of between
Mon1h~;rl-~D;ay:-t-.i.Year;;';;;-+I1"i1"'il
DOW~-tTi'""une=--L-tgBusine5sl~'
="U:::~±=nt:rnName=:-..;...o.";"';;"';:::--'-=":":'---"""';"''':'-'_'''''''''''':''::''--'----~Business=·=-:-is'''':a--:vidt-,·,...-4m
hi

MAR 1 7 1999
City

Residence Address

a:
II!

i:
~

It"

rName

(last. F"IISt, Middle)

e,.e, c. It A

c.-:r

·SU

Racii

'<NJr

M

\..U
Resldence Phone

IlnformationptOYlded

~ S-., ,

Yes

J<r~(i\ Dr."........ ..-t-

State

S7£"LA-c..O()~

'1l.."O· r-\C-N£.lI.. lSlJ\-lVt>

0

Business Phoiiii

Resid8nce Phone

'DOB

<'JI{,cft

Business Phone

I
City

ResIdence Address

S\ale

OOB

RaCl

Zip

()

t,vSp

~Pl.(l..

s: 1---r~Name~~(~Last~. ':!!:A~rs:-t,:":M~idd~le~)-------------'T: rl~nfonna~~tIo~n~provIded~~:------nR~8SlCl8=tnce~l~Plhone~--"'Buslne~~SS~P1l~o,.ne~-~
ResIdence Address

City

IName (Last. Arst, Middle)

Race

I

S-1

~ Clothing, tanoos, scars, peculiar mar1ls of identiflC8t1on
()

Wl--~

I~S)
I

0

City
Address

Employer/school

State

SociaJ Security Number

Charge(s)

Io

0
0

VICtim

-r:-;===-===-::':~==~~=-

--r

~ Type of ptemises

0

Stolen

Recover~

0

W:MI

rillmpound

IAdditional description or lealures

Premises Ioc:t<ed

IMethod 10 gain enlJ'y and point ot entry

OCCupanI(S) ptesenl I

IA-2.1 t '1 ~~

ISlate
I "Nil;

License No.

lYe;,,.)~

G ... ,....

o

HBDCompiainant

Total SLoss (approx.)

fgnitionunlod<ed
rOther agencylCase number

0

I tt4ol\POVWO R..£.'~T
~t-r S-(!\1'''!.MWO,ID bUSt' ftto 0 \~

0

Burglaryllarceny

K Crime Analysis

~if~e;;~ D.

Supervisor reviewing

0 cCPU
0 Auto theft

0

j 10,000

CIO SCreener

Cferll No.

O~\O,C\

DalelTime

I t..'l..oO
OatolTime

--

~~ S"nu,A'kJ""

-

IOtherpersonSiunilSnolified S ~

IwSp-

11..

r=.Ii.-w'u"\""""'SOl-J
~C.I(A ....511 M 1::- l-{~f.R.C-

'~Orug Enforcement

t6

S-i
Owner notified by

ICIO SC1eoper , A11;
ff
I ~J1M
..,A

0 Cho<:kSlFraud 0 Special Assa
0 Robbery
0 Homicide

Oz,~;~No.

Reason for hold

j'Estimated S Value Radionolifted

bVSr Ci.'\-C'O z.:t..o S

(}oof)

Otticer(s} reponing

s <l S \ "LO'H& 7

0 Yes
Keys in ignition

OIll8rrelatedrepor1SD£,A.fl.< lAIV~l.OU. ~UST"

Copies to

~c..\ q

Hold

0 Payments overdue 0
0 Oo<usunlodl8d
0

Recovered vehicle condition (damage, ilems stripped, etc.)

ru

Injury involved

Address

Divorce or separation in ptogress

i.{)wsr of*tt.f/t

o

KCJ

flv

Address

0

Follow·up recommended

OY~

VIN

'V'

:=

0

O~~

Model

Make

:f Vehicle disposition (" lowed, fist towing company, address and phone)
~ 'TVw tt>
Siolen vehicle

o Booked

t-=0:::;"",",,"Aid~'....;requ~ir~ed~----I

Uc..
W Registered owner

II:

KCJ

Oy~

Business Phone

Type of weapon. inslrument or force

q I=~~=-=-=-

0

0

Dri\l8rs IicenseilD card no.

Trademar1ls of suspect(s)

o Suspect

Residence Phone

Zip

Alias Name(s)

Clolhing, tanoos, scars, peculiar mar1ls of identification

~

Booked

O~~

-,-;Race==--.LI:Se_X--.;:~IID_al_e_o'_Bir.;'rt;:::h==r;;:::=IHgt_·_+'Wi::g1-=r·=~IIHa-.::i7:r
:-::-l1_IEY_e_s-j

=:--

Residence Address

.

/Stale

::--~-.-:'~~-----_......I_-----r=---~-~~~~--~~~~"';";';'~"';;~~

~U) ~S-:72=rl-Na-;me-;-;-(:-:last-=-'_A_rsl_'_M_idd_Ie_}

~

Business Phone

DrIvers flC8nseJlO card no.

Social Security Number

DOB

IHgt

Resldence Phone

Zip

AlIas Name(S)

Address

Employer/school

Isex IDale of BIrth

State

City

Residence Address

sex

State

Vice Conlrjll

1-~~~ /~ewing

IlmlC8r/mvestigator ass&gne<l

I ,""l:;, I JOI
0 CIS
0 PrOsecutOf

0
0

-

3 -j7-79
/"'\
r 1

a -" (J)) Ino;)//q9

-

I

Use fonnats on reverse side when listing additional vicllms, witnesses. and suspects.
Incident Number • t
I. Ust additional victims. witnesses and reporting persons. S. List properly taken, damaged. etc.
Co B
(!)"1
2. List additional suspects.
6. VICtims lnjuries-<lelails and where medical exam occurred.
- ~ 't, I
3. List additional vehICles.
7. Physical eVidence·what and where found. by whom, disposition.
4. Vehicle inventory.
8. Reconstruct incident and describe details 01 investigation.
1Iem# Quan

AtllCle

i,

tN

Tl-\. £.,

i:S.C;-1'

1---+-_-;'_-"'_

c..t,..",

D

~ SEM 1\-1:..

serial

WA-:SHI""~N

ltV

't\I\f:.

-n- ,-

I\<r :\'\S:Li

~lt.l~cz.·t

Sf-A"

I
b

I

..liscel:.3neous (co!ot $iz". WOOl. etc. \

STAT£. IPf\1lt.oL-

I

.'1.{
I

U
I

'~ I

l'

Oot.1r Vaw

~u{)£.tt c.o (.~ ~ _ _- I

~ ~h..~
GA-1tn.~t't ,SLV""PiI':b

A- V£."'t.\..t.l,..E,. b J -r"-S" ).Jig

S-rvrp£f.:'l"1b h..)V£;"S·r\t-J\lfE.

MMt-\f~(l 1.,1.'1
O~

Modet

Brnr.d

-

n

ht""~

C<JU\A-

rc,?uJ~
i

Utv

·V\

R.e.(l"~~\~ ~ ~ PLn.

C-<X.."l'" " ......

rJ\

- - - i - - - - - -..··--__, : - - - - - - - - - - - - - - I

~-tti
; ...

_I1
...
Z

W
~
~

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I _

_.

._. -'-j'
.___

II:
W

~

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---1-' -

_

--;

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r
I ·

I

I, Ihe undersigned. hereby declare this 10 be a true and correct reporl I understand Ihalliling a 1,lise report can be considered hindering. obstructing orl
delaying a police officer, a crime punishable under RCW 9a.76.020.1 understand Ihall musl nOllfy !he police departmenl immedIately upon the recovery
01 any ,lems reported stelen or missing. I willieslily as a wllness against 1he delendant when he/st·e is charged with a cnme.

0

I

0

I desire my vehicle 10 be impounded lor
salekeeplng. at my expense II il is recovered
and I am not immediately available 10 claim it.

~~t:~eralioll o;~e~~~;Iowe~ ~xerclse O~lion

I

--I---------L.-.------!

.

The described vehicle !';is been released to me and I will prolecllhe Director •
01 Public Salety Irom any and ali suits. costs. damages or any expenses
i
whatsoever which might occur with the release ollhis vehicle 10 me.

~npound

V~I~~:'edescri~:-c.

~el;~ve

K;~'9~I

10'
Ihe
01 W::i:9
on the
I hereby
amI re!ease ';0 County 01
olficers and employees trom any and all responsibility lor the described vehicle and its cont!:'nls. a~,j Irom any damage or ha~lIhty yo/hich might arise as a
result 01 the use of said vehict,'C by lhe par1y to whom I have release,d it. or from any claim ot dama;:;:> or loss wh'ch mighl anse as a result 01 leaving said
vehicle parked alollgside a counly slreel or road al my direction.llurlher agree to hold harmless tt~e County 01 King, its otk;ers and employees, Irom any
and all claims which might artsa as a result 01 my election to waive Impound 01 the described vehicle.
!

Signalure.

_L_

.

Date_

_ -_.

.'..

0

Registered Ovmer

0

legal Owner

0

Agenlol

l

KING COUNTY POLICE
PATROL OFFICERS' DEATH INVESTIGATION CHECKLIST

•.•

DATE
\

~

CASE I

0' Lt <t

Refer to Training Bulletin 8.15 for the guidelines for the use of this checklist. If,
after the completion of any of the following it ~~comes apparent that a crime has
occurred, secure the scene and notify the.Major trimes Unit.
t. Time call received
~. tt l
..:::;;:..-,.;..-.--2.
Arrival time
....llto~):....-'__
3.
How death was estab 1i shed (I.e. Skeletonized ....ins. Putrefaction. or Decapitated. In all
other circu-stanoes. cc.petent -.cHeel euthoritles
Bullatin 8.15 for p:JSslble exceptions)

M{':J~\t.S.

4.

5.

2 c30
A ltJSf
Time Sergeant notified.

~

- (>o}~d~\'!
~1~1~r-

be

su~

{)(lVC-

if practice! (refer to Training

~b.

_

Note the weather condit'lons U_perature. raining or cloer. etc.) if the vicUa,is found outdoors.
Be wry spec if ic as to the effects of those noted WGIlIther c:ondi tions on the vicUa or on evidence
it..-s. U.e•• body wera. ground frozen. body wet. ground dry. etc.).

CviJY1t - l'J \ IjH,1 ') "to 4)

6.

Q>te in the ~~ Dnd dayt i-e telephone nullbers of any fire deperhent or ellbulance personnel at the
s-c::enc. O>tein the yellow copy of the fire depert-ent report. it available. and attach it to your
' .
of fense report.

S~.A""'J\~ ~la lS ~£.PT. - \0 M

Ws P -

1.

T(t.Oop£R

trOc..u.A-

W\'-'L.LNV\I\.SO~

~ S-l

c..c.JHl'" A-l,v).

I

ldentl f)' end interview persons at the scene. Verify who found the body. describe the circuastences,
and note whether the body or scene had been .,ved or el tared prior to your arrival.

8.

Make e careful .mlk-through of the arN where the body is loceted. Hotethe generol conditions of
the house or area where the body is/wos located. look for ony signs of e struggle. forced entry,
burglery. robbery. or any other evidence thot .culd lead you to suspect D criae hos Occurred.

Ve:IJI,Cl-E.
f1).;rv

~

9'r~\'\.o{'l~
IV I ,(tVS

P/V

,/l---r '( IV l T(t 0 c-t.v. c'(a 'IV

(7vlA::os OV\N
KCDPS [-183 11/89

Officer's name

U'\tvy VQC£t\.1.

t)

CL-Ej)-tV
1"'"116(,..£

IN511)£.

rs ')

Pers. I 0"7.. 1 '} l
(Continued on reverse)

ORIC~iNAL

.'

9.

10.

Jf the YlcU. Is Inslet. a house or buUdlng. note the Inside t.eporature. tflerastat . .ttl!'SJ. ,and ,
the JOSltJon of doors lind windows (OJ*' or closed).

Without disturbing the body. carefully look for .lgns of t,..,. that . y indicate. crl. has occurred.
Describe the location end position in which the body Is found. Describe obvious WlUnds. 'inJuries.
blood or other stains. or tom or -.ssed clothing. Are yislble post-mrt_ UYidity steins consistent
with the present position of tfle body?

5uI\r

r=vutVVj

rl\1{ {.v C-lR

11.'

12.

6'\ VJSf

ll\J

\lr;..k\c~. ~{'l,\vE.R.i POS\1"IcJ~ S\..\I~r(D

TO"",Mtf}

ro~ l\IUN.

List the yicti.'s naee.' date of birth. and address.
.
8JhlC1€tr I ,'3rz.vc-f 14.J\-C.. ttJ
...... ~
II b ~ I t ' ) o '- tt 13A-l'l.(t. ( f'5 k "'\ c;, \

t

Cf<n"b

\Me. 1\1£ \l...

()

,]:Sl~b 1St £: \L.A-to l'"'\

vJ It--

<3 'l,.v

;.

"f1 Y Y

Atte.pt to detenl1ne It the YlcU. Is under the care of a doctor for eny reason. If possible. obtain
the doctor's neee and telephone IUllber. Interview awlleble relatives. friends. and neighbors ebout
the prior condition of the yicU.'s physical end _ntel heolth.
lJ N ~""" '\N o.J

13.

Att_pt to obtein the no.. telephone

~r.

end address of

the 'detl.'s next of Un.

Lv", p ,..., ~(,. I tVC-,

14.

On ell suicides. or when requested by the patrol supervisor or Major Cri8es. the scene end bod)'
should be photographed; the bodY. physical evldenc:e. and eny weopon$ triangulated and diagra.oo.

15.

Advise the Medical Exa.iner (22)-'232) of JOUr Investigation and provide hi. with eny info,..Uon
requested. If the Medical Exa-iner authorizes releese to e prlwte funeral hoee. specify which one
In the narrative of the Offense Report. List the Medical Exa.iner's CaSe Ntmber in box 6' of the
Offense Report. end the neee of the Medical Exa-lner's in\'8Stlgator in box 61.

I~.E

16.

\.tM-~£ft.C-

4,'\-(?"L~U

ClUE- 1:S

'The coepleted deeth Investigation Oft.nse Report MUST fully explain JOUr investl~t1on and cleerly

articulate any infor.sUon which Iwlps classify this Incident as a natural deeth. eecidental deeth.
or II suicide. List the description. location. lind disposition and photos. weapons, suicide notes.
or other physical evidence found at the scene. It a auleld8 note is retained by the Medical Exe_lner.
include It's werbaU. ee-ents In the nerraU.. of the offense report.

\

.'

DISTRICT CASE

WASHINGTON STATE PATROL

FIELD DIAGRAM

I LOCATION:

ON DE
OS OW

MILES

OF

AND
COUNTY

TYPE ROAD SURFACE
WEATHER: CLEAR

1J/t3 .I;-!;

ON

BETWEEN
ON DE
OS OW OF

FEET
MILES

0

OVERCASTD RAINING

D

mLDlU.::J

TID CASE NO

S
2". :z.oo.J1l 0 t!CYO&d·
I

INTERSECTING WITH

NO.~ -

kink::

0

SNOW 0

DRVD

WET

SNOWING

0

FOG

,

EACH DIRECTION

0

RESIDENTIAL 0

RURALD
ICED

BUS.

OTHER
,
TEMP.

OTHER

0
OF

LIGHTING

VISIBILITY:
ROADWAY:

STRAIGHT

0

CURVED

0

LANES

STRIPING _ _

GRADE

LOCATION

TRAFFIC CONTROL DEVICE(S)

POSTED SPEED

e~

N

TH

~

~

(

~

;

IN

I

..

I - p~

V

.-

~~

--

).~

\

\

i-

""'~

1::>.

~
~

I

~

I--:,)

r

I

~

.r~

II

~\

IN

J

r;

!'

I

I

l

bt-

-r-:=

1
\

\

oN

<:

I'r,; F
19 '" II

~
I~
~

~

I l\

'\'

Ii

-c:..

Il~

f~

3

1

~ W~~

I

~3

~

I~.

~ 1.-

......:

~ ~

~

<:

t..

t:..

.

~

(~

~ J;-~! I -

U 11 ILl
MEASUREMENTS BY:
WSP.fOO·143

.\,

M .....Qdk..

(8/90)

tOt

~"

_

I

r.

0

1\1 A

AND

_

·583'08-

IS.

1. t .5.K.J.:;.5.w.QiQ(

m.u;g;

...W

At...

.¥t.c....

M

,,(.,..tJo.a.XCt.(.Q.iQ. . " ..

.3.Wi

.. ,C.kiQ.J.

...t .c,QI

. .it.4tt4M::.

.~r--------------------------------'--_----:"'''':''''''''''

• .

COORDINATE MEASUREMENTS

LEGEND (example)

B
A

.i\

RP

n,/

••

20

10

10

o

E

/

BASE TAPE
20

A-IDENTIFY
B-IDENTIFY
C-IDENTIFY
D-IDENTIFY
E-IDENTIFY

30

40

50

60

W_ N __
E_ N_
E __ S __

C

1) PLACE BASE TAPE ALONG FOG, SKIP, CENTERLINE, OR PAVEMENT EDGE.
2) TWO MEASUREMENTS ARE REQUIRED TO LOCATE "SPOT", ONE ALONG THE BASE TAPE FROM THE
(RP) REFERENCE POINT TO THE 90 0 TAPE, AND ALONG THE 90 0 TAPE FROM THE BASE TAPE TO
THE SPOT.
3) RECORD MEASUREMENTS IN LEGEND. IDENTIFY WHAT IS BEING MEASURED. THE BASE TAPE MEASURE·
MENT IS RECORDED FIRST, FOLLOWED BY THE 90 0 MEASUREMENT. DIRECTION IS RECORDED BY
POINTS ON THE COMPASS (N,S,E,W). BASE TAPE CAN BE PLACED ON EITHER N.S. OR E.W. AXIS.
4) IF TRIANGULATION IS NECESSARY, USE BASE TAPE AS POINT TO MEASURE FROM.
5) LOCATE REFERENCE POINT (RP) TO A TANGIBLE OBJECT.
SKIDMARKS

CRITICAL SPEED SCUFF (YAW) RADIUS

1) MEASURE LENGTH OF EACH SKIDMARK. DESIGNATE
BEFORE OR AFTER IMPACT.

YAW

Af/OOtE

90~01NArE

2) DETERMINE IF ANY OVERLAP OF FRONT AND REAR
SKIDMARKS.

ANGtE r ItkEN A ~
FROM '

CltOFlO
,

3) USE COORDINATE MEASUREMENTS TO LOCATE SKID·

MARKS IN RELATIONSHIP TO ROADWAY OR LANE.

~

MIOPOI
Nr

1) MEASURE CHORD AND MIDDLE ORDINATE

USE 30 FT., 40 FT., OR 50 FT. CHORD.

DETERMINING INTERSECTION ANGLE

2) OBTAIN A CHORD AND MIDDLE ORDINATE FROM

EACH YAW MARK.
3) OBTAIN 2 CONSECUTIVE CHORDS AND MIDDLE OR·

MEASURE THREE

4) USE COORDINATE MEASUREMENTS TO PLOT YAW

SIDES OF A
TRIANGLE -

DINATES FROM ONE YAW MARK.

A, B, & C

MARK IN RELATIONSHIP TO ROADWAY OR LANE.

HEAD ON OR REAR END COUISIONS
ANGULAR COLLISION

- oc:::::::::::.

P.0 .1.

•SKIDMARKS

APPROACH SKIDMARKS

OF VEH. NO.1

OR

APPROACH

A,-------~

1) LOCATE POINT OF IMPACT.
APPROACH SKIDMARKS

OF VEH. NO.2

1) DETERMINE ANGLE OF APPROACH AND BOTH DEPAR·
TURE ANGLES BY PLOTTING SKIDMARKS USING
COORDINATE MEASUREMENTS
(SPOTS A THROUGH F)

2) INSURE THAT ANGLE MEASURED IS THAT OF DEPAR·
TURE, NOT THE ANGLE FROM POINT OF IMPACT TO
POINT OF REST.
068'563-

2) MEASURE DISTANCE AND DIRECTION VEHICLES

TRAVELED AFTER IMPACT.
3) DETERMINE IF WHEELS SKIDDING OR FREE WHEEL·
ING AFTER IMPACT.
4) MEASURE SKIDMARKS BEFORE IMPACT.
5) SPEED OF ONE VEHCILE PRIOR TO IMPACT.
6) USE COORDINATES TO PLOT SKIDMARKS IN RELA·
TIONSHIP TO ROADWAY OR LANE.

.n

\~fll'\(.n}'\

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TROOPJ:R C\. -\ \1 \
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\

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3-10-99 2000

'\UJ·~,Jl~r

01. ~.! I'.' ..• 11

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,\OI{lflt)J- ,')20tlTIIO,\ IIIERI(;fll

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'il,q hb. 'lInd I·'

h' ~(ilhlll~

: ,lIr:"t:d a: lh.'

\1..lj.IL. :::'; '1,\1111 :ht"

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1IIt'.'~1

,,"'u.:,II,. "Ill' \,·IIl,h..' all,I.",;'1

fl""jl':l

,~'I:,l' ".~,I'\li~Ii:t·i;"

I<I.I{ II:·' tU' ( I. \HI ,I, '\1)1:1< 1'1''\ \/.1' Of- I'U{.I( 1<\ l '\IH H IIH I. \\\ Iood)l
IIIL~I \lrt)J \\..\SIII,\(;IO,\ 111\11111 \11 \( IIH)lHP()I-U~ \IH 11{1 ~ ''\D

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ORIGINAL

o PRIMARY OFFJCER'S REPORT
o DETECTIVE'S REPORT

LB ASSISTING OFFICER'S REPORT

WASHINGTON STATE PATROL

REPORT OF INVESTIGATION

PAGE_OF_

location ollncldenl

I ~(~ :rS

SUspect No. 2 (last, First, t.4)

Suspect No. 1 (last. First, M)

Street Address

Home Phone

Street Address

HomoPhone

CIty, Stale, Zip Code

WodtPhone

CIty, State, Zip Code

Work Phone

Driver's license ,

Drivef's Ucense ,

ooe

ooe

Campt

Dale Booked

SCaI$, Matks, Talloos

Location Booked

Scars, Marks, Tattoos

State
HeIght

CompI

Dale Booked

Location Booked

EmployllflOccup

EmployerlOccup

VICtim No.1 (Lasl, Rrst. MI
Streel Address

Home Phone

Streel Address

Home Phone

City, Slale, Zip Code

Work Phone

CIty, Slale, Zip Code

Work Phone

ooe

Driver's license ,

Driver's License ,

DOB

EmployerlOccup

EmployllflOccup

Street Address

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~ ASSISJlNG OFFICeR'S REPORT
DETECTIVE'S REPORT

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(7) SUSPECrS INJURIES & WHERE TREATED
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(11) WEAPON USED (INClUDe MANUFACTlJRER, CAlIBER, STYlE & FINISH)
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(13) OTHER AGENCIES AND RELATED CASE NUMBERS

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REPORT OF INVESTIGATION

PAGE_OF_

Type of Investigalion

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Home Phone

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Driver's Ucense •

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IJ ASSISTING OFFiCER'S REPORT

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REPORT OF INVESTIGATION

(1) ADDITIONAl SUSPECTS
(2) ADDITIONAl VICTIMS
(3) ADDITIONAl WITNESSES (INClUDE FIRE AND AID PERSONNa)
. (5) VICTIM'S VEHIClE & LOCATION .
(6) PARTS I PROPERTY DAMAGED & APPROXIMATE DOllAR AMOUNT
DATE

TIME

PAGE

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SUSPECT'S INJURIES & WHERE TREATED
VICTIM'S INJURIES & WHERE TREATED
PHYSICAL EVIDENCE, WHERE FOUND, BY WHOM AND DISPOSITION
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(13) OTHER AGENCIES AND RaATED CASE NUMBERS
(7)
(8)
(9)
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o PRIMARY OFFICER'S REPORT

WASHINGTON STATE PATROL

o ASSISTING OFFICER'S REpORT
o DETECTIVE'S REPORT

REPORT OF INVESTIGATION
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Driver's LIcense ,

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I certify (declare) under penalty of peljury under the laws of the state of WashIngton that the attached reports are true, correct, and accurate
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o ASSISTING OFFICER'S REPORT

REPORT OF INVESTIGATION

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(2) ADDmONAl VICTIMS
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(6) PARTS I PROPERTY DAMAGED & APPROXIMATE DOLLAR AMOUNT
DATE

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(8) VICTIM'S INJURIES & WHERE TREATED
(9) PHYSICAL EVIDENCE. WHERE FOUND, BY WHOM AND DISPOSITION
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