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Rocords Section Onty Complginont I.D. seattle Police Depar tment OK TO DISCLOSE DO NOT.OISCLOSE NOT DISCUSSED INCIDENT NUMBER DATETIME REPORTED z/850P79 15 w3/ M. 79-270335 OFFENSE REPORT Offense AND ARREST ZARREST REPORT TYPE OF OFFENSE TYPE OF OFFENSE WITH ARREST CRIME ARRESTEO FOR BurglAny DATETIMEOF OFFENSE/AND/OR ARREST UNIT FILE NUMBER x0eo Hes 07oo Hies LOCATION OF OFFENSE AND/OR ARREST CENSUS TRACT SECXOR 0.700 W ComoDoe W Y Ooa ViCTIM NO.Last-Firs-MiddIo FIRM NAME IF BUSINESS OCCUPATION RACE SEXAGE 3ATELL PACIFIC NW. LABRATOry ADDRESS OF VICTIM P CODE RES.PHONE BUS.PHONE 666 BATEeLE BLvD. RIcHLAuD 935 Go9) He2Q78l ADORESS ZIP CODE RES PHON WITNESS NO. {Last-yrst-Middle} ADDRESS ZIP CODE RES.PHONE b6 NONE 3 REPORT/Entty: b7C SUSPECTNO. Last-First-Middlo DRES RES.PHONE SCHOOL ATTENDS VON DONS: "UNIFORM COMPLAINT/CITATION NO. DIAECT BOK CHARGE BAIL ..is copy was prepared 1 Dpartmcnt crp-eaale) breb COMPL. HAIR EYES OCCUPATION b6 b7C tcr the puipose TATTOOS, SCARS, MARKS, PECULIARITIES (agency) QAS.COMSATIVE RESISTANCG ORDHYSICAL AGGRESSION ATTEMPTED OR ACHIEVED AGAINST THE OFFICER h {if yes, complete form YES {8) PROpeRty DAmAGED - DESCRiBE DAMAGE AnD INDicaTE AmOUnT OF LOSS. 9 PREMISES -OR VEHICLE OF VICTIM ANO WHERE PARKED. t19) DESCRIBE ENTRY-WHERE AND HOW. AND TOOL USEO(For burglary and lorcony car prowl reports). ) RECONSTRUCT iNCIDenT. A 12) TIME AND LOCATION WHEAE VICTIMS ANO WITNESSES MAY BE CONTACTED E [6) PHysiCal EVIDencE, WHere FOUnD. sy whom AND LATER. BY FOLLOW-UP INVESTIGATORS. 113) PARENT'S OR GUARDIAN'S NAME. ADDRESS, AND PHONE. NUMBEA I M 7VICTIM'S INJURIES, AND WHEAE MEDICAL EXAM Juvenile (s) placed in datontion OCCUARED. (14) LiSt wRiTteN StAtEmenTs lOFFicER's. ViCtim(S), wItneSS(ES), SUSpeCt (S) b7E 9 10 12 CA ENT D/C CCN7AD 443279 0:082174 T. 20091 s457 Tharoby doclare the facts herein rgnwrtod b me. ara truo and corroct. I undor- Stgnature stond thot by titing a falso reporge may bo sgbjoct to criminal prosocution. RECORDS DETS REC CT. UNIT ID JUV. OTHER .CSDS C INVESTIGATING OSSICE: UNITINVESTIGATING OFFICER SERIAL UNIT APPROVING b6 b7C Fo5.5 Cs21.17R0V3/78