BORCE INCIDENT DATA REPORT ‘THIS FORM MUST BE COMPLETED ANY TIME AN OFFICER USES STRENGTH AND SKILL TO SUBDUE A SUBJECT, SPRAYS A SUBJECT OR ANIMAL WITH O.C. SPRAY, DEPLOYS THE TASER, Report!_ Jno 3- obs Incident # Date:[[-3o2°, _ Time:_J sige Location:_/o S¥ _Amgrive Officer/Rank: Jr ke Code #:__069 “Assignment:_J<(4 of ye) Subject Name: Lucy Feank- Mech Sex: M (®) Race; 0.0.8. 225 -Sg Location of Incident: JO 8 & eo Arrested ¥)/ N Charges:_ie $754 ing se ze. 4 Incident involved the officers we of Physical Strength & Skill Taeties {if physical strength and skill, please describe the tactics used. Knee SY ti ke Sle iS* raid S. O.C. Spray Taser {If 0.C. Spray or the Taser was used, please complete the following: 1. Did it reduce the resistance of the subject? Yes No 2. Were the effects immediate? Yes How many 1/5 second bursts were necessary? 1. # more Mechanical problems with sprayer/ gun? Yes Was anyone injured by the O.C. spray/ Taser? Yes__— No __ If yes, name who did not recover: Suspect: Officer: 16. How long did it take the suspect to recover? 0-20 minutes__ 30-40 minutes___ 20-30 minutes _ more than 40 minutes (specify) 7. Type of decontamination effort made. Air Water Other (specify) /8. Medical attention required because of O.C. Spray/Taser Yes No. 19, Suspect information A. Was the suspect: Intoxicated Been drinking Under the Influence of drugs - ‘Mental Subject B. Physical Description: Age Height Weight 10. Was 0.C. Spray / Taser used on an animal? Yes No Ifyes, please specify type of animal. Name of Correctional Officer Notified: Signature of Superior Notes: Je (LOZ Diges elaad Shi Rae 7 Comments: Use of Force oud te EA. Please write on back if necessary. MeFORCE INCIDENT DATA REPORT ‘THIS FORM MUST BE COMPLETED ANY TIME AN OFFICER USES STRENGTH AND SKILL TO SUBDUE A SUBJECT, SPRAYS A SUBJECT OR ANIMAL WITH 0.C. SPRAY, DEPLOYS THE TASER. Report#_2003 J536 Incident # son) Time:_2o2o_H®S Location: Jeoo F5% Officer/Rank: ike /Eccgie F Code# 2060/2064 Assignment: Patrol Subject Name:_Xw Her, Date SexXQPF Race /D_v.0.B12-+° 74 Location of Incident: /2pe 7-34 Arrested: Y/N Charges: 43. ‘wbire Serva, POSS FCS Incident involved the officers use of: Physical Strength & Skill Tactics O.C. Spray Taser Ie physical strength and skil, please describe the tacties used. _ Sfon Sr hheg Jo back Ee {if 0.C. Spray or the Taser was used, please complete the following: 1. Did it reduce the resistance of the subject? Yes___No___ 2. Were the effects immediate? Yes___ No 3. How many 1/5 second bursts were necessary? 1. __ 3: # more J4. Mechanical problems with sprayer/ gun? Yes No 8. Was anyone injured by the O.C. spray/ Taser? Yes___ No Ifyes, name who did not recover: Suspect: Officer: 6. How long did it take the suspect to recover? 0-20-minutes___ 30-40 minutes 20-30 minutes more than 40 minutes (specify) 7. ‘Type of decontamination effort made, Air Water__ Other (specify) 18. Medical attention required because of O.C. Spray / Taser Yes No. 9. Suspect informati A. Was the suspect: Intoxicated __ Been drinking, Under the Influence of drugs Mental Subject B. Physical Description: Age Height Weight |}10. Was O.C. Spray / Taser used on an animal? Yes No tyes, please specify type of animal. [Name of Correctional Officer Notified toa Signature of Supervisor Nbtffied: _ Comments: Please write on back if necessary.FORCE INCIDENT DATA REPORT, ‘THIS FORM MUST BE COMPLETED ANY TIME AN OFFICER USES STRENGTH AND SKILL TO SUBDUE A SUBJECT, SPRAYS A SUBJECT OR ANIMAL WITH 0.C. SPRAY, DEPLOYS THE TASER, Report? MOOE-ASI2T _ Incident # Date:_9=2 9 # Time:_1 74) Location: _b 52a Lexi ngs Officer/Rank: Ke ‘Zz __Code#:_Jo Assignment: Oa4 co) w Subject Name Bogelg Gail Haredaga Sex: M(F) Race:_@- D.0.B: 3-93-67 Location of Incident: 6520 Le yvinglon Arrested (2) N Charges Dwr 32 Dw Incident involved the officers use o! Physical Strength & Skill Tacties 4. O.C. Spray Taser: It physical strength and skill, please describe the tactics used. Se body pweight- Oem by Opt, re igeet If 0.C. Spray or the Taser was used, please complete the following: Did it reduce the resistance of the subject? Yes “No ‘Were the effects immediate? Yes___ No How many U5 second bursts were necessary? 1. 2 # more. Mechanical problems with sprayer/ gun? Yes No ‘Was anyone injured by the O.C. spray/ Taser? Yes___- No _ Ifyes, name who did not recover: Suspect: Ofieer: }6. How long did it take the suspect to recover? 0-20 minutes___ 30-40 minutes 20-30 minutes more than 40 minutes (specify) 7. Type of decontamination effort made. Air Water Other (specify) : 8, Medical attention required because of 0.C. Spray / Taser Yes No 9. Suspect informati A. Was the suspect: Intoxicated Been drinking Under the Influence of drugs Mental Subject B. Physical Deseription: Age Height _ Weight 10, Was O.C. Spray / Taser used on an animal? Yes No If yes, please specify type of animal. _ Name of Correctional Officer Notified: = Veunnt Signature of Supervisor Notifies DESCRIBE THE INCIDENT IN DETAIL ON THE BACK OF THIS PAGE,Page:1 Use offorce 1A NoAMIBNAMS Received: Dec 19, 2005 08:00 Case No: 2005-034137 Type of service belng performed at time of incident: Not Used Reason for use-of-force: Resisting Arrest Cicer assessment of ctizen condition: Ccizen was injured: No CCizen was taken to hospital: No Citizen was charged/arrested in relation to the incident: YesOfficer was Injured: No ‘Officer was taken to hospital: No Involved citizen: John E. Nelson Resistance(s): Failto Obey Commands Resisting Arrest Injries/condtions: Not injured Linked address(s): Complainant address: 609 North Beaumont TX 77701 Officers involved: Officer David T. Burke [2069] Officer current info: Division: Patrol Shift: Fourth Watch Zone/Unit: Zone One ‘Snapshot - officer information at time of incident: Badge/ID no: Dhision: Patrol ‘Shit. Fist Watch Zone/Unit: Zone Taree Supervisor: Sgt. Bean Rankytie: Officer ‘Age: 39 Yeats of employment: 12 Years with unit: In uniform: Yes Off duty: No Off duty employed: Yes Use(s) Of Force Holding: EffectiveInjuries/conditions: Not Injured ‘Summary: ‘Sgt. Gus submitted a Mandatory Use of Force form for strtength and agity ‘When/ whe Date/time occurred: Dec 18 2005 14:20 Incident Location: 4145 Dowlen Road Beaumont TX County: Jefferson Status/assignment information: Status: Completed. Priority: Low (Opened: 12/19/2005 Assigned: Due: Completed: 12/19/2005 Disposition: Documentation Only Unit assigned: Internal Afar Handled at feld/unit level: Yes Outside/file investigator: Investigator assign: Sergeant Wiliam Stanford Supervisor assign: Un-assigned Source of information: ctizen Organizational component(s): Division: Patrol Shift: First Watch Zone/Unit: Zone Three ‘Supervisor Sgt. Bean 1m Stanford on Dec 19, 2005 at 08:57 Poge:2FORCE INCIDENT DATA REPORT ‘THIS FORM MUST BE COMPLETED ANY TIME AN OFFICER USES STRENGTH AND SKILL TO SUBDUE A SUBJECT, SPRAYS A SUBJECT OR ANIMAL WITH 0.C. SPRAY, DEPLOYS THE TASER. Report#_DOO - 34137 Incident # Date: /I-)$-08" Time: AZ, Location: FI4 5 Dowsleyr Lees, Officer/Ranks [2 ocke /Z Code #13 of/2067 rn Padres Subject Name: AJC a7 do na Elden Lowe -SexsQD F Raced S_ pop: 24S Location o atuler Kea Arrested N ESE P Pest = Lael PoE ‘Incident involved the officers use of: wo [Physical Strength & Skill Tactics_2~_ O.C. Spray Taser Tt physical strength and skill, please deseribe the tactics used. __ Arm bar rok fC Bar FS eo If 0.C. Spray or the Taser was used, please complete the following: 1. Did it reduce the resistance of the subject? Yes 2, Were the effects immediate? Yes 3. How many 1/5 second bursts were necessary? 1. # more | 4. Mechanical problems with sprayer/ gun? Yes 5, Was anyone injured by the O.C. spray/ Taser? Yes__ tyes, name who did not recover: Suspect: Ofticer: 16, How long did it take the suspect to recover? 0-20 minutes 30- 40 minutes 20-30 minutes ‘more than 40 minutes (specify) 7. Type of decontamination effort made. Air Water___Other_ (specify) 8. Medical attention required because of O.C. Spray /Taser Yes No. 9. Suspect information: ‘A. Was the suspect: Intoxicated Been drinking Under the Influence of drugs Meatal Subject B. Physical Description: Age Height 110, Was O.C. Spray / Taser used on an animal? Yes No Ifyes, please specify type of animal. Weight Name of Correctional Officer Notifi Signature of Supervisor Notifi DESCRIBE THE INCIDENT IN DETAIL ON THE BACK OF THIS PAGE.Page: 4 Use force 1A No: NMI Received: Dec 22, 2005 08:00 case No: 2005-094514 “Type of servic being prfomed at me of incident: Reason fr use of force: Resisting Arrest Ooftcer assessment of eizen conto: Caen wes ined: No Citizen was taken to hospital No Citizen was charged/restd in relation to the incident: YesOfcer was Ijured: No Officer was taken to hospital: No Involved citizen: Aaron Charles Hill, Resistance(s): Evading Arrest Fall to Obey Commands Injuries/oonditions ‘Not Injured Linked address(s): ‘itzen invoWved address: 4050 Goliad Beaumont TX 77705 officers involved: Officer David T. Burke [2069] Officer current info: Division: Patol Shift: Fourth Watch ZonefUnit: Zone One ‘Snapshot - officer information at time of incident: Badge/I0 no: Divison: Patrol Shift First Watch Zone/Unit: Zone Three Supervisor: Sgt. Bean Ranke: officer ‘Age: 39. Years of employment: 12 Years with unt Tn uniform: Yes OFF duty: No Off duty employed: No Use(s) OF Force: Fashiight: NOT effectivePage: 2 Baton: Effective Officer Nicholas B Thompson [20044] Officer current int Division: Administrative Shift: Traning/Personnel Zone/Unit: Snapshot - officer information at time of incident: Badge/10 no: Divison: Patrol shits Zone(Unit Ranke: Offcer ‘Age: 30. Years of employment: Years with units TMuniform: Yes Of duty: No Off duty employed: No Use(s) OF Force Holding: NOT effective Tnjures/conditons: Not Injured ‘Summary: Sgt. Reaux submitted a mandatory use of force complaint on Officers Burke and Thompson. Officer Burke ‘used his Nashlight and baton during an arrest. When/where: Date/time occurred: Dec 22 2005 02:11 cident Location: 1780 Euclid Beaumont TX 77705 Precinct: 3C County: Jefferson Linked Word documents: Linked files: Status/assignment information: Stats ED Por ee ee orepostion Unit assigned: Handled at feld/untt eve! Outside/hile investigator: Investigator assign: Supervisor assign: Unassigned Source of tnformation: officer Organizational component(s): Entered by: Sergeant William Stanford on Dec 22, 2005 at 09:30 Page:3Page:1 Uso ottore TANABE recived De 22,2006 08:00 case No: 2006-03391 Type of service being performed at time of incident: Reason for use-oF force: Resisting Arrest Officer assessment of eizen conition: Cizen was injured No Citizen was taken to hospital: No Ctizen was charged/arested in relation ta the incident: YesOfier was injured: Yes Officer was taken to hospital: No Involved citizen: Leo Mouton Resitance(s): Fail to Obey Commands Resisting Arrest Injuries/conditions: Not Injured Linked address(s: Cizen Involved address: 885 Washington Beaumont TK 77705 Officers involved: Officer David T. Burke [2069] Officer current info: Division: Patrol Shift: Fourth Watch Zone/Unit: Zone One ‘Snapshot - officer information at time of incident: Badge/ID no: Divison: Patrol ‘Shift: First Watch Zone/Unit: Zone Three Supervisor: Sgt. Reaux Rankgtite: Officer ‘Age: 40. Years of employment: 13 Years with units In-uniform: Yes OFf duty: No Off duty employed: No Use(s) Of Force: Baton: NOT effectivePage:2 Holding: Effective Injuries/conditions: Injured/Refused Treatment Officer Jose F. Ornelas [16022] officer current int Division: Patrol Shift: Fourth Watch Zone/Unit: Zone Three ‘Snapshot - officer information at time of incident: Badge/I no: Division: Patrol Shift: First Watch Zone/Unit: Zone Three Supervisor: Sat. Cole Rankytile: Officer ‘Age: 46 Years of employment: 4 Years with unt Inuniform: Yes. Off duty: No Off duty employed: No Use(s) OF Force: Flashlight: NOT effective Injuries/conditions: Not Injured ‘summary: Sof. Moree submited the necessary paperwork In reference tn a Mandatory Use of Force complaint in whlch Officer Burke used his baton as an impact weapon When/where: Date/time occurred: Dec 16 2008, Incident Location: 1830 Irving Beaumont TX 7701 County: Jefferson Linked files: Status/assignment information: Sas ED Priya pene ED sion AS OD Ono: dspostion STUnit assigned: angled at feld/unit level Outside/file investigator: Investigator assign: ‘Supervisor assign: Un-assigned Source of information: officer Organizational component(s): Division: Patrol Shift: Fist Watch Zone/tint: Zone Three Supervisor: Sat. Reaux Entered by: Sergeant William Stanford on Dec 22, 2006 at 09:21, Page: 3Page: 1 Use otforce TA No:SININNNNN Received: 320, 2007 23:30 case No: 2007-19304 Te of serves being pefomed a te of Incdent easn fr use of fore: Resting est ofcer assessment of eizen condition: Caz was inured No Cotzen vas taken to hospital No ‘Aizen was charged/arrested in relation to the inci fesOficer was inured: No Officer was taken to hospital: No Involved citizen: Richard Perkins Resistance(s): Fall to Obey Commands Resisting Arrest Injuriesconditons: Not Injured Linked address(s): Complainant address: 1985 Rafes Way Beaumont TX 77706 Officers involved: Officer David T. Burke [2069] Officer current info: Division: Patrol Shift: Fourth Watch Zone/Unit: Zone One ‘Snapshot - officer information at time of incident: Badge/ID no: Division: Patrot Shift: Fist Watch Zone/Unit: Zone Three Supervisor: ‘Sgt. Reaux ankytitle: Officer ‘Age: 41 Years of employment: 13. Years with unit: In uniform: Yes. OF duty: No Of duty employed: No Use(s) OF Force: Verbal Commands: NOT effectiveFashlight: Effective Injures/condltions: Not Injured Officer witnesses: Officer current info: Dhisig shift Officer current info: Division: shit: Zone/UNt Officer current info: Officer Burke struck a subject with his flashlight who was resisting arrest, When/ where Dateftime occurred: Jul 20 2007 23:01, Incident Location: 4115 Sparks Beaumont TX 77705 Precinct: County: Jefferson Linked Word documents: Linked files: Status/assignment information: Page: 2Sats EE °° i i Signature of Supervisor Notifiec ‘Comments: C Please write on back if necessary.co JEFFERSON COUNTY Keg - (26 bo. Affidavit for Arest Warrant Class C Offense Report: nee |x [aps [x Ics: Other Summons: sso. |x [cy [x + dosignad ffian a PEACE OFFICER unr he nv of TEXAS and bing dy sworn, Os oath makes the following statements an accusations | ISTHE DELIEE OF 1. RSTRND BEHEREDY CHARGES AND ACCUSED, THAT ON OR ABOUT pasareet [acre [Tore Conn _[ foe vs tm [prsxsm: | ati Contiburor ORE | 1290100 Rentaapnnny a Aaa Jen so in amen HTS i ~apimone =a paca i é os aaa ae FIANT HAS PROBABLE CAUSE FOR SAID BELIEF BY REASON OF THE FOLLOWING FACTS: [D/T 12/31/2008 20:33 Hours Wednesday Tea uove date and ume, Toficer Burke with the Beaumont Police Department was dispatched tothe rca of AVE D and Milam in reference to subject shag onthe side ofthe road with a Santa Hat on Upon aval othe area 1 observed said subject laying on the grass near the roadway. He was aaa Be sa as Reber Onis, DOD 01/08/1955. He had the strong odor ofan alcohol beverage on his breath and peron, and be fel dven wien be remTes Fas ser were sassy and bloodshot, and his speech was sured and lethargic. 1atempied to take MR. Ortiz to his residence and eens him (0 sed te adult owever he could not tell te where twas. e was arrested fr Publi Intoxication and transported tothe Jefferson County Jal He was Teleased to jail taf with no incident Frese ai ts At the tie oF thc actual arrest, Ortiz became resistive and combative. He refused to get into the patrol unit ia handeuffs and had to be tased for him to comply. JOIEREFORE, ott isan of an res wan a il aoe hin atte sbove decibel penenaFFIANT DT hi BenaT ORE GIATDEE wy SWORD anbefreme ys So TE Soma beanie he “T Burke Beaumont Police Department #1 STE ‘THE STATE OF TEXAS “To any Peace Officer of the State of Texas, GREETINGS: YOU ARE COMMANDED to take the body of to answer the State of Texas fr an offense against he Laws of aid Stato, to-wit ‘which offense e iw acoused by the written afidavit of a8 sei forth above WHTNESS my signature on the __ day of 20, MAGISTRATE OFFICE BOND: S, RELEASE ON PERSONAL RECOGNIZANCE BOND AT __O°CLOCK__A/M on__20__ PNLESS CHARGES AREFILED BY THE CRIMINAL DISTRICT ATTORNEY OR BOND IS POSTED. TAMIKA YARBROUGH etary Publ State of Texas ‘CammisionEsies| ACTOSER 15.2011 Pease ete caver fr mips Cine