AKRON POLICE DEPARTMENT
ADVANCED TASER USE REPORT
Date/Time of Incident: __________________________

Incident Rpt. # _______________________

Location of Incident: _____________________________________________________________________
Supervisor notified: ___________________________________________
Type of Force used or Displayed by Subject (check all that apply)

On Scene: Yes / No

( ) Physical

( ) Impact

( ) Cutting Instrument ( ) Firearm ( ) Other Explain:
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Type of Force used by officer(s) (check all that apply)

( ) Physical

( ) O.C. Spray

( ) Baton

( ) Less Lethal ( ) Firearm ( ) Other Explain:
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Injury description (if any):
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Treated by: EMS

Hospital

Admitted to hospital: Yes / No

Subject under the influence of: Drugs / Alcohol / Other

List substance if known: ________________

Summary of action of the officer(s) involved: _________________________________________________
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Subject Data
Subject's Name: __________________________________
Age: __________

Sex: __________

Height: __________

Weight: __________

Race: _________

Clothing description: ____________________________________________________________________

Application Data
Advanced Taser serial #: ______________________

Cartridge serial #(s): ________________________
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Number of cartridges fired: _____
Number of stun contacts: _____

Number of probe contacts: _____
Number of probes penetrating skin: _____

Laser sight activated only: _____
Location of each probe contact: ____________________________________________________________
Distance between probes (use inches): _______________________________________________________

Length of time for electrical current application: ( ) Programmed 5 sec. If longer/shorter or more than
one application explain total time frame involved:
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Approximate distance of probe launch: ______________________________________________________
Did the application cause an injury to the subject or others? Yes / No if yes, explain:
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Did the Advanced Taser application gain compliance from the subject?

Yes / No

Subject's demeanor after the Advanced Taser was displayed or deployed:
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Where were probes disposed? _____________________________________________________________
Additional Information
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Officer Submitting this report: ______________________ Supervisor Approval: _____________________