COMPLAINT - SUMMONS SOMPLAINT NUMBER THE STATE OF NEW JERSEY 1608 s 2020 | 002122 vs. a SHELIM KHALIQUE PATERSON MUNICIPAL COURT ‘ADDRESS, 111 BROADWAY 16 GATES PLACE PATERSON Ng 07505-0000 973-321-1515 countyor_ PASSAIC WAYNE Ng_ 07470-3217 FOUGHARGES | CODEFIS | POUCE CASE = DEFENDANT FORMATION 4 SEX M EYE COLOR BLACK DoB: 02/06/1969 COMPLANANT pan ae DRIVERS LIC. DLSTATE NO NAME: petmuaiek Br SOCIAL SECUR sale pros TELEPHONE # ‘TRENTON ns_09625 LIVESCAN PCN i By ceriicafion or on oath, the complainant says that To the best of his/her knowledge, information and belief the named defendant on or about 05/12/2020 in PATERSON CITY , PASSAIC —_County,Nadid: WITHIN THE JURISDICTION OF THIS COURT, BETWEEN ON OR ABOUT JANUARY 1, 2020, AND MAY 12, 2020, IN THE CITY OF PATERSON, IN THE COUNTY OF PASSAIC, AND ELSEWHERE, KNOWINGLY DID VIOLATE OR KNOWINGLY DID AID OR ABET ANOTHER IN VIOLATING THE PROVISIONS OF N.J.S.A. 19:63-1, ET SEQ., THAT IS, THE SAID SHELIM KHALIQUE DID KNOWINGLY TAKE OR ATTEMPT TO TAKE OFFICIAL MAIL-IN BALLOTS FROM ONE OR MORE VOTERS OR OTHER PERSONS HAVING CUSTODY OF SAID MAIL-IN BALLOTS FOR THE PURPOSE OF DELIVERING THE SAME TO THE PASSAIC COUNTY BOARD OF ELECTIONS, OR TO A POSTAL BOX OR POST OFFICE, WITHOUT SIGNING AND PRINTING HIS NAME ON THE OUTER ENVELOPE AS REQUIRED BY N.J.S.A. 19:63-27, IN VIOLATION OF N.J.S.A. 19:63-28 AND N.J.S.A. 19:63-27. WITHIN THE JURISDICTION OF THIS COURT, BETWEEN ON OR ABOUT JANUARY 1, 2020, AND MAY 12, 2020, IN THE CITY OF PATERSON, IN THE COUNTY OF PASSAIC, AND ELSEWHERE, DID POSSESS ONE OR MORE OFFICIAL MAIL-IN BALLOTS ISSUED TO OTHER VOTERS WITHOUT in violation of: Original Charge *) 157 63-28R Q 19st-2 fy 20:28-7At2) “Amended Charge CERTIFICATION: 1 cartity thatthe foregoing statements made by me are true. | am aware that if any ofthe foregoing statements made by me are wilfully fase, am subject to punishment. POWERS: Date: 06/25/2020 ig witness To @ law enforcement Offic juse determination fe not required prior to the YOU ARE HEREBY SUMMONED to appear before the SUPOiorCout Inthe counly ot: PASSAIC atthe follwing address: PASSAIC SUPERIOR COURT ew courruovse 7 macos st pxreason 1 07508-0000 Ifyou al to appear onthe date and athe tie stated below, a warrant may be issued for your ast Daten: ‘Appearance Date: 07/23/2020 Time: 99:00AM Phone: 973-653-2910 Signs of Person fssing Summons: BRIAN POWERS Date: 06/25/2020] 5 2 Related Traffic Tickets | Q Serious Personal injury! Death Domestic Violence - Confidential Groat Copeane re Special conditions of release: 2. No phone, mail or other personal contact wivictim ORIGINAL No possession firearms/weapons other (specify) Page 1 of 11 NweoRt 112017COMPLAINT - SUMMONS ‘COMPLAINT NUMBER 1608 | S | 2020 [002122 |S one xuanzove ‘COMPLETING THE BEARER INFORMATION REQUIRED BY N.J.S.A. 19:63-27, IN VIOLATION OF N.J.S.A. 19:34-3. WITHIN THE JURISDICTION OF THIS COURT, BETWEEN ON OR AROUT JANUARY 1, 2020, AND MAY 12, 2020, IN THE CITY OF PATERSON, IN THE COUNTY OF PASSAIC, AND ELSEWHERE, KNOWINGLY DID MAKE, PRESENT, OFFER FOR FILING, OR USE ANY RECORD, DOCUMENT OR THING KNOWING IT TO BE FALSE, WITH PURPOSE THAT IT BE TAKEN AS A GENUINE PART OF INFORMATION OR RECORDS, AND WITH PURPOSE TO DEFRAUD OR INJURE ANOTHER, THAT IS THE SAID SHELIM KHALIQUE KNOWINGLY DID PRESENT OR OFFER FOR FILING TO THE PASSAIC COUNTY BOARD OF ELECTIONS ONE OR MORE OFFICIAL MAIL-IN BALLOTS ISSUED TO OTHER VOTERS WITHOUT COMPLETING THE BEARER INFORMATION AS REQUIRED BY N.J.S.A. 19:63-27 WITH THE INTENT TO DEFRAUD THE PASSAIC COUNTY BOARD OF ELECTIONS, IN VIOLATION OF N.J.S.A. 2C:28-7. WITHIN THE JURISDICTION OF THIS COURT, BETWEEN ON OR ABOUT JANUARY 1, 2020, AND MAY 12, 2020, IN THE CITY OF PATERSON, IN THE COUNTY OF PASSAIC, AND ELSEWHERE, KNOWINGLY DID FALSIFY, DESTROY, REMOVE, CONCEAL, OR UTTER ANY WRITING OR RECORD KNOWING THAT IT CONTAINS A FALSE STATEMENT OR INFORMATION, WITH PURPOSE TO DECEIVE OR INJURE ANYONE OR TO CONCEAL ANY WRONGDOING, THAT IS THE SAID SHELIM KHALIQUE KNOWINGLY DID PRESENT OR OFFER FOR FILING TO THE PASSAIC COUNTY BOARD OF ELECTIONS ONE OR MORE OFFICIAL MAIL-IN BALLOTS ISSUED TO OTHER VOTERS WITHOUT COMPLETING THE BEARER INFORMATION AS REQUIRED BY N.J.S.A. 19:63-27, WITH THE PURPOSE TO DECEIVE THE PASSAIC COUNTY BOARD OF ELECTIONS, IN VIOLATION OF N.J.S.A. 2C:21-4A, ‘Original Charge 4) 2021-40 ‘Amended Charge COMPLAINT - SUMMONS Page 2 of 11 NuCDR WZOI7"COMPLAINT NUMBER. COMPLAINT — SUMMONS (court action) Related Traffic Tickets and Complaints: ‘Miscellaneous information, Adjournments, Companion Complaints, Co-Defendants, Case Notes: STATE V. 4998. ogz2 eusLin_saALrovE FTA Bail Information ‘Amount Bail Set $. by. Bail Recoa. Attached Feemed [ROR ‘Dato Refored to vacua eee mare —— ne 07/23/2020 | Q Advised of Rights by_ QO Yes O No ee aaa aman = = a a SS ‘Original Charge 1) 19:63-28A 7 19:34-2 3) 2C:28-7A(2) ‘Amended Charge eae aaa sanasaped [ne om se =e Aducatonromcom [EE oom "om om adie _Jaittime creat | Susp_ imp. _Jaittime creat |_Susp_unp_ _Jail time creat | Susp. imp_ Pichetionitem Susp imp ‘Susp inp [susp imp Sana Conaniy Sense aan TT aes ee as OE WeeaeNst or oe == —— Teer [a oe aes = co eecar SEA er 3 oa = = OV Since Fees | 5 = a i z = Restitution esi ‘ORIGINAL - Court Action Page 3 of 44 RUCORT i017"COMPLAINT NUMBER. COMPLAINT — SUMMONS (court action) STATE V. SHELIM KHALIQUE by G1 Bail Recog. Attached Dato Referred to County Prosecutor Related Traffic Tickets and Complaints: mare = ene 07/23/2020 | Q Advised of Rights by_ QO Yes O No Ss aaa aman = = a a SS ‘Original Charge 4) 2C:21-4a ‘Amended Charge aa LT eanasaped [ne om a =e Addcatonromcon [ESE oom "om om adie _Jaittime creat | Susp_ imp. _saittime creait | _Susp_ ump _Jail time creat | Susp. imp_ Pichelionitem Susp imp ‘Susp inp [susp imp Sona omaniy Sonee a Seats ee as == VCCBISNSF voce: 'SNSF: voce: ‘SNSF: vec: ‘SNSF Teer [a oe eS = co reioar STE er = oa 3 = DV SuhiOter Foes | = Ee = a = Restitution esi ‘Miscellaneous information, Adjournments, Companion Complaints, Co-Defendants, Case Notes: ‘COMPLAINT - SUMMONS (Court Action) Page aot NICORT 1712017‘PATERSON MUNICIPAL COURT 111 BROADWAY SHELIM ADDRESS 3 6 GATES PLACE THE STATE OF NEW JERSEY VS. KHALIQUE PATERSON NJ 07505-0000 973-321-1515 countyor: PASSAIC. WAYNE Ng_07470-3217 FOrGHARGES | CODEFTS | POLICE CASE? DEFENDANT INFORMATION 4 SEX M_ FYE COLOR BLACK pos: 02/06/1969 COMPLAINANT DL STATE: No NAME: BRIAN POWERS sale DRIVER'SUIC. SOCIAL SECURM TELEPHONE LIVESCAN PCN # defendant on or about 05/12/2020 in MAY 12, 2020, IN THE CITY OF PATERSON, PROVISIONS OF N.J.S.A. 1: 3-1, BOX OR POST OFFICE, AS REQUIRED BY N.J.S.A. 19:63-27. 19:63-27, By cerlfication or on oath, the complainant says that fo the best of his/her knowledge, information and belief the named PATERSON CITY WITHIN THE JURISDICTION OF THIS COURT, BETWEEN ON OR ABOUT JANUARY i, IN THE COUNTY OF PASSAIC, AND ELSEWHERE, KNOWINGLY DID VIOLATE OR KNOWINGLY DID AID OR ABET ANOTHER IN VIOLATING THE : ET SEQ., KNOWINGLY TAKE OR ATTEMPT TO TAKE OFFICIAL MAIL-IN BALLOTS FROM ONE OR MORE VOTERS OR OTHER PERSONS HAVING CUSTODY OF SAID MAIL-IN BALLOTS FOR THE PURPOSE OF DELIVERING THE SAME TO THE PASSAIC COUNTY BOARD OF ELECTIONS, THAT IS, THE SAID WITHOUT SIGNING AND PRINTING HIS NAME ON THE OUTER ENVELOPE IN VIOLATION OF N.J.S.A. WITHIN THE JURISDICTION OF THIS COURT, BETWEEN ON OR ABOUT JANUARY 1, PASSAIC County, NJ did: 2020, "AND SHELIM KHALIQUE DID OR TO A POSTAL 1 3-28 AND N.J.S.A. 2020, AND CERTIFICATION: MAY 12, 2020, IN THE CITY OF PATERSON, IN THE COUNTY OF PASSAIC, AND ELSEWHERE, DID POSSESS ONE OR MORE OFFICIAL MAIL-IN BALLOTS ISSUED TO OTHER VOTERS WITHOUT in violation of: ‘Original Charge a) 1963-280 19:34-2 ‘¥ 20228-TA(2) “Amended Charge Leery thatthe foregoing statements made by me are rue. | am avare that any ofthe foregoing statements made by me are wily ‘also, lam subject {0 pul Signed: ‘The complaining witness is a law enforcement officar and: Issuance of this Complaint-Summon: [SUMMONS ‘YOU ARE HEREBY SUMMONED to appear before the at the following address: PASSAIC SUPERIOR COURT wew courruouss: 77 HAMILTON SF ‘Suporior Court 06/25/2020 [probable cause determination is not required prior to th Ifyou fal to appear on the date and at the time stated below, a warrant may be Issued for your arrest. Date of arrest: ‘Appearance Date: ‘Sigs of Person Ising Surons 07/23/2020 BRIAN POWERS Inthe county of: PASSAIC Time: 99:00AM Phone: 973-653-2910 ato: 06/25/2020} 2 Related Traffic Tickets | Q Serious Personal Injury/ Death ‘or Other Complaints Involved. ‘Special conditions of release: @ No phone, mail or other personal contact wivictim @ No possession firearms/weapons Other (specify):STATE V. SHELIM KHALIQUE COMPLETING THE BEARER INFORMATION REQUIRED BY N.J.S.A. N.d.S.A, 19:34-3. 19:63-27, IN VIOLATION OF WITHIN THE JURISDICTION OF THIS COURT, BETWEEN ON OR AROUT JANUARY 1, 2020, AND MAY 12, 2020, IN THE CITY OF PATERSON, IN THE COUNTY OF PASSAIC, AND ELSEWHERE, KNOWINGLY DID MAKE, PRESENT, OFFER FOR FILING, OR USE ANY RECORD, DOCUMENT OR THING KNOWING IT TO BE FALSE, WITH PURPOSE THAT IT BE TAKEN AS A GENUINE PART OF INFORMATION OR RECORDS, AND WITH PURPOSE TO DEFRAUD OR INJURE ANOTHER, THAT IS THE SAID SHELIM KHALIQUE KNOWINGLY DID PRESENT OR OFFER FOR FILING TO THE PASSAIC COUNTY BOARD OF ELECTIONS ONE OR MORE OFFICIAL MAIL-IN BALLOTS ISSUED TO OTHER VOTERS WITHOUT COMPLETING THE BEARER INFORMATION AS REQUIRED BY N.J.S.A. 19:63-27 WITH THE INTENT TO DEFRAUD THE PASSAIC COUNTY BOARD OF ELECTIONS, IN VIOLATION OF N.J.S.A. 2C:28-7. WITHIN THE JURISDICTION OF THIS COURT, BETWEEN ON OR AROUT JANUARY 1, 2020, AND MAY 12, 2020, IN THE CITY OF PATERSON, IN THE COUNTY OF PASSAIC, AND ELSEWHERE, KNOWINGLY DID FALSIFY, DESTROY, REMOVE, CONCEAL, OR UTTER ANY WRITING OR RECORD KNOWING THAT IT CONTAINS A FALSE STATEMENT OR INFORMATION, WITH PURPOSE TO DECEIVE OR INJURE ANYONE OR TO CONCEAL ANY WRONGDOING, THAT IS THE SAID SHELIM KHALIQUE KNOWINGLY DID PRESENT OR OFFER FOR FILING TO THE PASSAIC COUNTY BOARD OF ELECTIONS ONE OR MORE OFFICIAL MAIL-IN BALLOTS ISSUED TO OTHER VOTERS WITHOUT COMPLETING THE BEARER INFORMATION AS REQUIRED BY N.J.S.A. 19:63-27, WITH THE PURPOSE TO DECEIVE THE PASSAIC COUNTY BOARD OF ELECTIONS, IN VIOLATION OF N.d.S.A. 2C:21-4A. ‘Original Charge: 4) 20:21-44 ‘Amended Charge eeRETURN OF SERVICE INFORMATION SOMPLAINT NUMBER THE STATE OF NEW JERSEY 1608 | S_| 2020 | 002122 VS. ao oe SHELIM KHALIQUE PATERSON MUNICIPAL COURT ‘ADDRESS, 111 BROADWAY 16 GATES PLACE PATERSON NJ _ 07505-0000 973-321-1515 _countyor_PASSAIC WAYNE Ng_07470-3217 | Fo CHARGES] CODEFTS. | POUCE CASE # DEFENDANT INFORITATION 4 Sex M_ EYECOLOR BLACK os: 02/06/1969 COMPTARANT BRIAR POWERS DRIVER'S IC. DLSTATE: NU NAME: 25 MARKET ST SOCIAL SECURITY # soe Bo Box 085 TELEPHONE # wa 0625 LIVESCAN PCN # By certification or on oath, the complainant says that to the best of his/her Knowledge, information and belief the named defendant on or about 05/12/2020 in PATERSON CITY + PASSAIC County, NI did: WITHIN THE JURISDICTION OF THIS COURT, BETWEEN ON OR ABOUT JANUARY 1, 2020, AND MAY 12, 2020, IN THE CITY OF PATERSON, IN THE COUNTY OF PASSAIC, AND ELSEWHERE, KNOWINGLY DID VIOLATE OR KNOWINGLY DID AID OR ABET ANOTHER IN VIOLATING THE PROVISIONS OF N.J.S.A. 19:63-1, ET SEQ., THAT IS, THE SAID SHELIM KHALIQUE DID KNOWINGLY TAKE OR ATTEMPT TO TAKE OFFICIAL MAIL-IN BALLOTS FROM ONE OR MORE VOTERS OR OTHER PERSONS HAVING CUSTODY OF SAID MAIL-IN BALLOTS FOR THE PURPOSE OF DELIVERING THE SAME TO THE PASSAIC COUNTY BOARD OF ELECTIONS, OR TO A POSTAL BOX OR POST OFFICE, WITHOUT SIGNING AND PRINTING HIS NAME ON THE OUTER ENVELOPE AS REQUIRED BY N.J.S.A. 19:63-27, IN VIOLATION OF N.J.S.A. 19:63-28 AND N.J.S.A 19:63-27. WITHIN THE JURISDICTION OF THIS COURT, BETWEEN ON OR ABOUT JANUARY 1, 2020, AND MAY 12, 2020, IN THE CITY OF PATERSON, IN THE COUNTY OF PASSAIC, AND ELSEWHERE, DID POSSESS ONE OR MORE OFFICIAL MAIL-IN BALLOTS ISSUED TO OTHER VOTERS WITHOUT in violat Original Charge 4) 1963-288 2 19934-2 3 20:28-7A(2) Cheek Certification by Police Regarding Complaint-Summons Teerlfy that | served the complaint-summons by delivering a copy to the defendant personally Teertfy that | personally served the complaint’ summons by leaving ‘a copy at the defendant's usual place of abode with a competent member of the _household of the age 14 or over Name of family member over 14 years of age | certify that | mailed a copy of the complaint-summons by ordinary ‘mail to the defendant at his or her last known address. aed sat Rn ooaeSS Toertfy that | served the complaint summons by delivering a copy ¥_| toa person authorized to receive service of process on the JOSEPH ROTELLA, ESQ. defendant's behalf. Name od tile of authorized person ‘Other manner of service: | certify that | served the complaint summons in the following manner: Tearlfy that was unable To serve the complaint-summons. Signed: BRIAN POWERS NJ DIVISION OF CRIM JUSTICE pate of Action: 06/25/2020 Name, Til and Deparment of Oficer RETURN OF SERVICE INFORMATION Page 7 of 11 Nucort 11/2017RETURN OF SERVICE INFORMATION ‘COMPLAINT NUMBER 1608 | S | 2020[ 002122) oe cxazzoue COMPLETING THE BEARER INFORMATION REQUIRED BY N.J.S.A. 19:63-27, IN VIOLATION OF N.d.S.A, 19:34-3. WITHIN THE JURISDICTION OF THIS COURT, BETWEEN ON OR AROUT JANUARY 1, 2020, AND MAY 12, 2020, IN THE CITY OF PATERSON, IN THE COUNTY OF PASSAIC, AND ELSEWHERE, KNOWINGLY DID MAKE, PRESENT, OFFER FOR FILING, OR USE ANY RECORD, DOCUMENT OR THING KNOWING IT TO BE FALSE, WITH PURPOSE THAT IT BE TAKEN AS A GENUINE PART OF INFORMATION OR RECORDS, AND WITH PURPOSE TO DEFRAUD OR INJURE ANOTHER, THAT IS THE SAID SHELIM KHALIQUE KNOWINGLY DID PRESENT OR OFFER FOR FILING TO THE PASSAIC COUNTY BOARD OF ELECTIONS ONE OR MORE OFFICIAL MAIL-IN BALLOTS ISSUED TO OTHER VOTERS WITHOUT COMPLETING THE BEARER INFORMATION AS REQUIRED BY N.J.S.A. 19:63-27 WITH THE INTENT TO DEFRAUD THE PASSAIC COUNTY BOARD OF ELECTIONS, IN VIOLATION OF N.J.S.A. 2C:28-7. WITHIN THE JURISDICTION OF THIS COURT, BETWEEN ON OR AROUT JANUARY 1, 2020, AND MAY 12, 2020, IN THE CITY OF PATERSON, IN THE COUNTY OF PASSAIC, AND ELSEWHERE, KNOWINGLY DID FALSIFY, DESTROY, REMOVE, CONCEAL, OR UTTER ANY WRITING OR RECORD KNOWING THAT IT CONTAINS A FALSE STATEMENT OR INFORMATION, WITH PURPOSE TO DECEIVE OR INJURE ANYONE OR TO CONCEAL ANY WRONGDOING, THAT IS THE SAID SHELIM KHALIQUE KNOWINGLY DID PRESENT OR OFFER FOR FILING TO THE PASSAIC COUNTY BOARD OF ELECTIONS ONE OR MORE OFFICIAL MAIL-IN BALLOTS ISSUED TO OTHER VOTERS WITHOUT COMPLETING THE BEARER INFORMATION AS REQUIRED BY N.J.S.A. 19:63-27, WITH THE PURPOSE TO DECEIVE THE PASSAIC COUNTY BOARD OF ELECTIONS, IN VIOLATION OF N.d.S.A. 2C:21-4A. ‘Original Charge 4) 20:21-44 ‘Amended Charge RETURN OF SERVICE INFORMATION Page ® of 11 NUICDRT 112017PATERSON MUNICIPAL COURT 111 BROADWAY PATERSON 973-321-1515 NJ 07505-0000 COUNTY OF PASSAIC THE STATE OF NEW JERSEY VS. ADDRESS, 16 GATES PLACE WAYNE SHELIM KHALIQUE Ng_ 07470-3217 Fol GFARGES CODERS POLICE CASE DEFENDANT INFORMATION SEX M EYE COLOR BLACK Dos: 02/06/1969 COMPLAINANT BREAN POWERS DRIVER'S LIC. DLSTATE: NT NAME: 25 MARKET ST SOCIAL SECURITY # Sali: P 0 Box 085 TELEPHONE # c) ‘TRENTON Na 08525 [ivescan pens: Purpone Thi Avi Cerfontion ito more filly scribe he facts of th alleged fens so that a adge or aushorvd uit ofeer may determine 1. Description of relevant facts and circumstances which support probable cause that (1) the offense(s) was committed and (2) the defendant is the one who committed it: The investigation has revealed that on or before the May 12, 2020. the City of Paterson, Passaic County, Shelim Khalique approached a residence located in Paterson’s 2nd Ward and collected from one or more voters their official mail-in ballots for delivery to the Passaic County Board of Elections. These mail-in ballots were in fact subsequently received by the Passaic County Board of Elections without information identifying the bearer as required by N.J.S.A. 19:63-27. election inAffidavit of Probable Cause ‘COMPLAINT NUMBER. THE STATE OF NEW JERSEY 1608 | s | 2020 [002122 cnevim voxnxove |e ee) SHI HAD TOUS 2. | am aware of the facts above because: (Included, but not limited to: your observations statements of eyewitnesses, defendant’s admission, etc.) statement of witness, review of evidence received and records received during investigation. 3. If victim was injured, provide the extent of the injury: N/A Certification: I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punishment. Signed: BRIAN POWERS LAW ENFORCEMENT OFFICER Tate: 06/25/2020 Affidavit of Probable Cause Page 100f 14 wiao7Preliminary Law Enforcement Incident Report ee THE STATE OF NEW JERSEY 1608 Ss 2020 | 002122 VS. ————— SS SHELIM KHALIQUE PATERSON WONICTPAL COURT rooness, 411 BROADWAY 16 GATES PLACE BATERSON NJ 07505-0000 973-321-1515 counrvor PASSAIC WAYNE Ng_07470-3217 FaGHARGES [CODERS] POUCE CASE SEED RFORATON 4 SEX M_ EYECOLOR BLACK DOB: 02/06/1969 OMPCANANT BEAN POWERS DRIVER'S UC # DLSTATE: NZ NAM Se anager st SOCAL SECU sate Botox 08 Teuesrones ny TaENTON wa ose2s_ | LIVESCANPCN Purpose: The Preliminary Law Enforcement Incident Report (PLEIR) is intended to document basic information known to the officer atthe lime of ts preparation. Its recognized that additional relevant information wil emerge as an investigation continues. The PLEIR shall be in addition to, not in teu of, any regular police arest, incident, or investigation reports. Note thatthe PLEIR is specific to each defendant charged in an investigation “The charge was based on the cbservations/statenents nade by an eyewitness(es) “the offense/imeident was recorded using electronic/eurvetiance via! ‘scellphone Video ‘sorner/Explain seployer Ccerttieation: | certiy that the foregoing statements made by me are true, | am aware that if any ofthe foregoing statements made by me are wilfully false, | am ‘subject to punishment. Signed:___ BRIAN POWERS LAW ENFORCEMENT OFFICER pate, _ 06/25/2020 Preliminary Law Enforcement Incident Report Page 110f 11 7202018