ARREST REPORT

Agency Name ORI Date/Time of Arrest OCA

Mo Date Year
AGENCY
INFO.
Hrs.
Taken Fingerprint Card Check Digit # (CKN) Arrest Tract Residence Tract Arrest Number
Prints
Photos
Name (Last, First, Middle) D.O.B. Age Race Sex Place of Birth Country of
Citizenship
ARRESTEE INFORMATION

Current Address Phone Occupation Resident Unknown

Non-Resident

Employer's Name Address Phone

Also Known As (Alias Names) Hgt Wgt Hair Eye Skin Tone Consumed Drug/Alcohol
Yes No Unk
Scars, Marks, Tattoos Social Security # OLN and State Misc. # and Type

Nearest Relative Name Address Phone

If Armed, Type of Weapon On-View Criminal Summons Place of Arrest

Order for Arrest Citation Warrant
ARREST INFO.

Charge #1 Fel Counts DCI Code Offense Jurisdiction (if not arresting agency) Statute # Warr. Date
Mo Date Yr
Misd

Charge #2 Fel Counts DCI Code Offense Jurisdiction (if not arresting agency) Statute # Warr. Date
Mo Date Yr
Misd

Charge #3 Fel Counts DCI Code Offense Jurisdiction (if not arresting agency) Statute # Warr. Date
Mo Date Yr
Misd

VYR Make Model Style Color Lic/Lis Vin

VEH. INFO.

Vehicle: 1. Left at Scene Secured Unsecure Date/Time Hrs.

2. Released to other at owners request Name of Other
3. Impounded Place of Storage Inventory on File?

Date/Time Confined Place Confined Committing Magistrate

BOND INFO.

Hrs.
CONFINED

Type Bond Amt. Bond Trial Date Court of City

Written Promise Unsecured
Secured No Bond Other
Assisting Officer Name/ID Number Released By: Name/Dept/ID Date/Time Released

Hrs.
Status L = Lost S = Stolen R = Recovered D = Damaged Z = Seized B = Burned C = Counterfeit / Forged F = Found
Codes (Check "OJ" column if recovered for other jurisdiction)
Check up to 3 types of activity for each
DCI Status Quantity Type Measure Suspected Type
OF ARREST

Possess Buy Sale Mfg. Importing Operating

AT TIME
DRUGS
PLAIN-
COM-

Name: Complainant Victim Address: Phone:

ANT NARRATIVE

Arresting Officer Signature/ID # Date/Time Submitted Supervisor Signature

Mo Date Yr
STATUS

Hrs.
Case Status: Case Disposition: Arrestee Signature
Futher Inv. Cleared By Arrest / No Supplement Needed
Inactive Closed Arrest/No Investigation
DCI-608F Rev. 3/92