Incident/Offense

THIS SIDE OF FORM IS CONFIDENTIAL UNLESS RELEASED AT THE
DISCRETION OF THE CHIEF LAW ENFORCEMENT OFFICER
85 Agency Casll Nl.n'ober o Check' Multiple
Page2012
183 Oatil of Repon 184 TImIt of Repcn I=! AM
B6 Su1rtx 187 Offender
Report - Continued 10/01113 11:43:01 131001086
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88 RepcrtellBy 181 Vialm Or
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89 Sutftx 90 91 Home Phone
92 WOI1I Phooe
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181 Ruklent
o Non·Resident 93 Other Phone
94 95 ...,ctimNan-e
96Su1fi>< 97 Addre" (SIrMI, C4y, Slate, Zip) 98 HaM Phone
205-759-4421
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28 SAHAMA VILLAGE
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205·344-2880
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IMddiel
TUSCALOOSA AL , 35401
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AUL JOSEPH
101 EmployenScnool 102 Octupauon
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103 Address City, Stat .. , ZIp)
104 \oVcriI. Phone 205-344-2880
0 LAKE TABLE LLC SALEPERSON
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28 SAHAMA VI LLAGE, TUSCLOOSA,AL,35401
105 oen .. Phone

lOOSe 107 Raca 108 Language 109HGT 110'AGT 111 DateofBnh
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181 Eflgllih 0 Spllnlsh
5'09" 152 08/11/71
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1113 Elhnidty 117 11'1Juty
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121 W&apan.Used 122 De5Cl1pUon ofW3aponslRrearmilTools Used IflQf1ense o 0 Rlfte 0 Sholgun 0 \Jnmown
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123 Pl ee. olOcwrTenc.
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: [ """'0' 35 JACK WARNER PY
: NNool Iinlemlllinjury M Minor Inlury T otTIe'"
TUSCALOOSA
, AL , 35401 0 N l8 Broken Bonea
L llcerlluon o Clner M810r !(lJury U UnCOf1JaOUI LAW4
126 Circum IlIanc .. : HomIdde & Auautt ; I,''' "'M 1 '" T,"1m'" ""up", 'I
131 rre'lmllfl1 lOf R0lpe1
o Simple 0 Ye. DYe. o Ves
127l.oo1tion: Rape
I 0 Aggravated 0 No ONo ONo
132 Off _ .. ..... 'f1e (Lilt, Firat, Middle) 134 SFX 135 AWn 137Rac;;e 11385111( 11 ,an., .. <>fR.rth
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f I8IOther OlHR OSDat'lish OOlher
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146 Probal:1B 147 Ey, 148 Hair 149COtT1lleJQon 150 Armed
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EMPLOYED AT THE WOMENS CLINIC BRa GRY FAR DVel oNO
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a:: 151 Clolhf1g
15' 15'
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BLUE INORK UNIFORM
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15011 Name (La.I, Fir.tt, Middle) 1S6 SFX 157 AlIIII
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EMPLOYED AT THE WOMENS CLINIC BRa BLK MED DYes DNa
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181 Hom.
182 ' .... oric aQO.448-2542
W LAFERRERA JESSICA LYNN
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F W 09115175
426 lAKE VISTA OR
205·310.11749 183 OIher
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TUSCALOOS" AL , 35401
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1811 Home
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W 191 Diner
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19' 19'
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, .. 197 Home
198 WOrk
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199 Othlllr
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Copy 10 CID Value of sIgn is 90.00 doll ars
W Victim reported he had put out a sign at the entrance to the Medical Center, He then went 10 his designated area 10 protest the abortion center, A short
> lime later he was approad'ted by the Witness, who told him she saw an older white female and a younger black male take the sign off the roadway and put
i= the sign In the black Lexus (tag# ckrj) and drive towards the women's clinic inside the complex. The witness said the suspects both had on uniforms that
looked like they worked al the clinic. Police saw the older female going to her car and asked her if she and the younger black male took the sIgn, She
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said they thought the sIgn had been abandoned. She said the sIgn was in the car the black male was drIving. She stated he had left for the day because
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they were slow. She said she dId not know how to get in touch with him. She was ad\llsed to try and let him know if he returned the sign the victim might
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not prosecute, AI the time of this report the sign had not been returned. The victim will prosecute,
204 COllbnued on Supplement I LO:! AsII,llng Agerlq UHI I ;loti ASSisting Agency cue Number
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208 Warrant Signed
Warrant' I Add r..loMd
DVel ilSI No DVe. I2'l No Narrah .. e D Yes r&l No
I hereby affirm that t have read this reran and that all the information given by me is
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corred to the best of my knowledge. will assume full responsibility for notifying the
1 LI.t :!lale u ..
agency if any stolen propeny or missing person herein reported is returned.
Slonall.ll'.
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