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001 21:36 ANADARKO POLICE Z 04721795 314052477272 FE] oearw or oFFeNoen OKLAHOMA EJ EXTRADITION DENIED VICTIM REFUSED TO COOPERATE JUVENILE/NO CUSTODY UNIFORM INCIDENT/OFFENSE REPORT = XT infant () OFFICER SAFETY NOT CLEARED EXCEPTIONAL | | MODIFY APT. ¢ ) OFFICER ASSAULT - = [zj DELETE APT a) SFakesc 2 . f) O pee Avapake 2oLice Dey — ee o = ln OCCURRED: ON OR ao < [oA el os hous | 1 - TYPE OF REPORT * [-] PERSONS {_) VeHicLe (Cj vuvenne [1] ARSON-Loss $ [_) PROPERTY ([] ARREST [) CHILD ABUSE (J GANG RELATED (At INFORMATION (] Phone REPORT C)_bomestic uoLence ~ igus: | VICTIM (LAST, FIRST. MIDDLE) RACE ETHNICITY [Sex 00R AGE | HoT | wor | Hain | eves 10 et: TA QF QELAYeMA __ WB I AL HISP NON i ADDRESS {TY/STATEIZIP RES. -R IPHONE = Ce STATUS _N_ Zz BUS. ADDRESS CITY/STATE/ZIP MARITAL BUS PHONE ro) STATUS Q OR. LIC.# SSN TyPE : [JWONMOUALL, | FReaNciaL INSTITUTION [_JREUGIOUS ons. [K)OTHERS | 2 OP VICTIM] BUSINESS. [_]GOVERNMENT Ssocetyeunic [UNKNOWN |r TYPE OF INJURY CHECK UP TO S OF THE FOLLOWING TYPE OF INJURY - VW r?) APPLES ONLY TO OFFENSES LISTED BELOW N~ NONE () M ~ APPARENT MINOA INJURY ea KIDNAPPING/ABDUCTION ROBBERY PA T K . ONAPPINGIAG| ReORUaTED ASSAULT (1) B - APPARENT BROKEN BONES (} 9 — OTHER MAJOR INJURY FORCIBILE SODOMY SIMPLE ASSAULT C) '- possiae wnTEAwaL myey} T ~ LOSS OF TEETH SEXUAL ASSAULT, WITH AN OBJECT —EXTORTION/BLACKMAIL {_] L - SEVERE LACERATIONS (J U~ UNCONSCIOUSNESS yy FORCES FOMDUME LOCATION OF INJURY _——___ : ; ff RELATIONSHIP OF OFFENDER # OFFENDER # OFFENDER # VICTIM OF OFFENSE #27} | osel # - VICTIM TO OFFENDER(S}| CODE # CODE # CODE 7 FGI 4 ow romnegseoeaton OF OFFENSE GEO LOCATION AREL_. ore TO BREAKING & ENTERING ONLY CL) Foaciere 0 , ? Seti NUMBER OF PREMISES ENTERED ___ () No FORCE OFFENSE # CLASSIFICATION IBR CODE | artewer | ADDRESS/LCCATION OF OFFENSE _ |GEO LOCATION = comp m PREMISE TYPE NAMI. IBR CODE|HATE / BS| CODE APPUES TO BREAKING 6 ENTERING ONLY _[_] FORCIBLE . YES NO _NUMBER OF PREMISES ENTERED __ ()_NO Force TYPE OF CRIMINAL ACTIVITY ENTER UP TO 3 FOR EACI4 OFFENSE INDICATE TYPE OD APPLIES ONLY TO OFFENSES USTED BELOW B ~ BUYING/RECEIVING Gy LCTTER COUNTERFEITING/FORGERY © + CULTIVANING/MANUFACTURING/PUBLISHING io) STOLEN PROPERTY OFFENSES D ~ OISTRIBUTING/SELLING OFFENSE # = ORUGS/NARCOTICS VIOLATIONS & + EXPLOITING CHILOREN —_ — Im DRUGS EQUIPMENT VIOLATIONS © - OPERATING/PROMOTINGI/ASSISTING . Zz wi] GAMBUNG EQUIPMENT VIOLATIONS P ~ POSSESSING/CONCEAUNG OFFENSE HO 7) PORNOGRAPHY/OBSCENE MATERIAL T = TRANSPORTING/TRANSMITTING (IMPORTING =a WEAPON LAW VIOLATIONS U - USING/CONSUMING it|TYPE WEAPON/FORCE INVOLVED — ENTER UP To 3 FOR EACH OFFENSE INDICATE WE APON/FORCE 2) ro) APPLIES ONLY TO OFFENSES LISTED BELOW 1 AREARO CIRCLE ‘a’ IF AUTOMATIC BY NUMBER > MURDER 6 NONNEGLIGENT MANSLAUGHTER 12 - HANDGUN A OFFENSE # m onc vse -rete 13 - RIFLE 7 —_—-—TIe iN FORCBLE RAPE 4 ~ SHOT A OFFENSE # __. «___-+|o FORCIBUE SODOMY 5 - OTHER FIREARM A SEXUAL ASSAULT. WITH AN OBJECT 20 ~ KNIFE/CUTTING INSTRUMENT FOACIBLE FONDUNG 30 - BLUNT OBJECT — ROBBERY 35 - MOTOR VEHICLE OFFENDER(S) SUSPECTED OF USING AGGRAVATED ASSAULT . 40 ~ PERSONAL WEAPONS SIMPLE ASSAULT 50 - POISON AT Time oF offense CL) c-comeuTER EXTOATION/BLACKMAIL 60 - EXPLOSIVES 90 ~ OTHER OR SHORTLY BEFORE [J p-prucs WEAPON LAW VIOLATIONS 65 - FIREANCENDIARY DEVICE 95 - UNKNOWN OFFENSE OCCURRED 70 = ORUGS/NARCOTICS 99 - NONE C) A~ALCOHOL 1T 13 UNLAWFUL TO FALSELY REPORT A CRIME REPORTING OFF LcER Dz REVIEWED BY iD # WILL YOU PROSECUTE: ( Y/") REPORTED By: UCR NIBRS1 : = nt eae a wok ee 8/93 / IU AAC<S 6/20 ~ ||