Page
1
of
2
0.03.01.0 (12/91)
DH
11/1/98)
0
OMBINED
VID.
REPORT
MULTIPLE
ORS
ON
HIS
REPORT
I-
00
UCC
(0
U.
o
wtY
M
PRELIMINARY
CASE
SCREENING
~ ~
NOT
SEEN
O
RINTS
OR
OTHER
EVIDENCE
NOT
PRE
TEl
MO
NOT
DISTINCT
18
PROPERTY LOSS
LESS
THAN
$5000
O
NO
SERIOUS
INJURY
TO
VICTIM
Et
ONLY
ONE
VICTIM
INVOLVED
;C 4
PREMISES
(SPECIFIC
TYPE)
Single
Family
Residence
ATM
ENTRY
S963FV
O
RONT
O
EAR
O
IDE
O
OOF
O
LOOR
CI
OTHER
VICT S
VEH.
POINT
OF
NTRY
POINT
oaxir
q
Los
Angeles
Police
Department
PRELIMINARY
INVESTIGATION
of
RAPE
INVEST
DIV.
HWD
OR
0406
lsgi
LAST
NAME,
IRST,
MIDDLE
FIRM
IF
BUSINESS)
ADDRESSR-SEXDESCAGE
DOB
I
ZIP
(
8-
DR.
1C.
NO.
IF
NONE,
THER
D
S
O.)
LOCATION
OF OCCURRENCE
FOREIGN
LANGUAGE SPOKEN
IF
APPLICABLE)
PHONE
OCCUPATION
SAME
AS
VS
0
ES.
D
US.
R.D.
PRINTS
a
Y
PREL.
ATTEMPT
N
OBTAINED
METHOD
DATE
d
TIME
OF OCCURRENCE
4/25/03
0300
DATE
IME
REPORTED
TO
PD
6/6/04
2200
INSTRUMENT
TOOL USEDTYPE PROPERTY STOLEN
LOST
DAMAGED
In
3.4
GIVEN
IF
INVOLVED)
EAR, AKE, YPE COLOR.
IC.
NO.NOTIFICATIONS
(PERSON
6
IVISION)
STOLEN/LOST
RECOVERED
EST.
DAMAGEDARSON
VAND
CONNECTED REPORTS
(TYPE
6
DR)
to
•
MO
F
0,1151LQAM
LIST
UNIQUE ACTIONS.
IF
SHORT FORM
DESCRIBE
SUSPECTS
ACTIONS
N
BRIEF
PHRASES,
NCLUDING
WEAPON
USED.
DO
NOT
REPEAT ABOVE
NFO.
BUT
CLARIFY
z
REPORT AS NECESSARY.
F
ANY
OF
THE
MISSING
ITEMS
ARE
POTENTIALLY
DENTIFIABLE, ITEMIZE
AND
DESCRIBE
ALL
ITEMS
MISSING
IN
THIS INCIDENT
IN
THE NARRATIVE.
SUSP
aquaintance)
exually
assaulted
the
victim
while
she
was
passed
out.
The
victim
woke
up
while
the suspect
was
having sex
with
her
and
struggled
with
him.
The
suspect
choked
he
victim
until
she
passed
out.
OWo
_,
L
•
Ce
<
t
Zrnz
CI
v=
0)
•
REPORTING
INITIALS,
LAST
NAME
SERIAL
NO.
DIV.
/ DETAIL
EMPLOYEE(S)
D.
yers 34498
HWD/SEX
t)ERSOpl
REPORTING
MOTIVATED
BYDOMESTIC
El
HATRED
PREJUDICE
D
VIOLENCE
SIGNATURE
OR
RECEIVED BY
PHONE
IF
SHORT
FORM
ANO
ICTIM /
PR ARE NOT THE SAME, NTER PR
INFORMATIONNOTE:
IN
INVOLVED
PERSONS
SECTION.
Complete below
sections
If
any
Preliminary
Case
Screening
boxes
ere
not checked.
SUSP'SVEHICLE
YEAR
MAKE
MODEL
TYPE
Interior
COLOR:COLOR(S)
S-1
SEX
M
DESC
-oVEH.
LIC.
NO. STATE
HAIR
BRO
EYES
BLU
HEIGHT
510
PERSONAL
ODDITIES
(UNUSUAL
FEATURES, SCARS. TATTOOS.
ETC.)
S-2
O
BUCKET SEATS
0
DAMAGED
INSIDE
Exterior
B
1
CUSTOM WHEELS
2
PAINTED INSCRIPT
LEVEL
ALTERED
4
RUST
RIMER
5 CUSTOM
AINT
0
VINYL
TOP
Body
DAMAGE 13
5
IGHT
8
2
ODIFIED
8
FRONT
3
TICKER
7
REAR
LEFT
Windows
O
DAMAGE
0
RIGHT
0
OUST.
0
FRONT
CURTAINS REAR
0
LEFT
WEIGHT
AGE
CLOTHING
NAME, ADDRESS, DOB,
F
KNOWN;
NAME, BKG.
O.,
CHARGE,
F
ARRESTED.
155
28
Masterson,
Daniel
Peter
Weapon
(VERBAL THREATS,
FORCE,
IMULATED GUN,
TC.
IF
KNIFE
OR
Bodily Force
INVOLVED
PERSONS
W2
W3
W.
ITNESS
R
•
ERSON
RPTG.
S
PERSON
SECURING
455)
D
•
ERSON
DISCOVERING
450)
P
PARENT
CP
•
ONTACT
PERSON
DOMESTIC
VIOLENCE)
ADDRESS
CITY
ZIP
PHONER-
LA
90027
NAME
SEX DESC
008
F
w
DR.
IC.
NO.
IF
NONE,
IST
OTHER
D
&
O.)
FOREIGN
LANGUAGE SPOKEN
(IF
APPLICABLE)
M
W
30yrs
M
25yrs
COMBINED
EVID.
RPT.
USE
HIS
SECTION
N
LIEU
OF PROPERTYREPORT
F
NO
GUN AND NO
MORE
THAN
THREE
TEMS
OF
EVIDENCE
B
R•
B
-
LA
90027
R-
unk
address
B.
LOC.
VID.
BKL),
10.10
GIVEN?
Y
N
Preliminary
Drug
Test
SUPV./INV.
OFCR.
ESTING
N
WITNESS OFCR. SER. O.
ITEM
QUAN.
ARTICLE
SERIAL
NOJTYPE TEST'
OF DRUG
BRAND
DRUG
EIGHT.
UNITS
MODEL
O.
DRUG
TEST
RESULT
MI
SC.
NARRATIVE
CONTINUATTION
u
FO
MBDESCR
BE
D
EVIDENCE INC
L
R
U
ED
CE
O
PVI
T
NI
U
S
C
T
O
A
C
T
C
E
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L
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))
U.4
4
S
R2T
THER
DETAILS,
NCL.
WHEN
AND
WHERE
PERSONS
WITH
NO PHONE CAN BE
LOCATED.
5)
INDICATE
TYPE
OF
TRANSLATOR
NEEDED
FOR ANY INVOLVED
PERSON.
61
LIST
ITEMS
ISSING.
VIC 1M
INDEMNIFICATION
INFORMATION
(IF
APPLICABLE)
IS
ANY
OF
THE
ICTIM S
PROPERTY
MARKED
WITH
AN
OWNER
APPLIED
DENTIFICATION
NUMBER?
IF
"YES"
EXPLAIN
N
NARRATIVE. YES
El
NO
0
APPROVALAND
REVIEW
SU E
VISOR
APPROVING
Cr
r\YI
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SERIAL
NO.
,
IA
E
1
0
.2ed)
CW7T
OAT
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I
E EP
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DETECTIVE
SUPERVISOR REVIEWING
SERIAL
NO.Category
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PAGE
NO.
2
F
2
TYPE
OF
REPORT
RAPE
BOOKING
NO.
DR
NO.
0406
j 35 7
ITEM
NO.
OUAN.
ARTICLE
I
SERIAL
NO.
BRANDMODEL
NO.
MISC.
DESCRIPTION
EO COLOR,
IZE.
INSCRIPTIONS, CALIBER,
REVOLVER,
TC.)
DOLLAR VALUE
U
W
F/W
W5
Mlunk
6
W6
Mlunk
W7
Munk
W8W9
F/unk
See
INJURY
REPORT
DR
40619357
or report
narrative
REDACTED REDACTEDREDACTED REREDACTED REDACTEDREDACTED REDACTEDREDACTED REDACTEDREDACTED REDACTED
