Gloria James

4
COMPLAINT/ARREST AFFlDAViT ( - SCE CASE, NO 1 2011 . 00039320 [ HEIGHT WEIGHT ' HAIR COLOR HAIR.LENGTH HAIR STYLE EYES GLASSES FACIAL HAIR TEETH 5 06140 ELK'MED BUS BLK PLACE OF BIRTH (Ciry Slete/Counlry) USA. LOOM. ADDRESS (Street Apt Numhpr) (City) (Stale) (ZIP) PHONE CITIZENSHIP 1168 KINGSRIDGE BLVD WADSWORTH, OH USA PERMANENT ADORESS'(8lrael Apt Number) q HOMELESS CI UNKNOWN (City) (Stale)Ceunlry) (ZIP) PHONE OCCUPATION OTHER q 'BUSINESS OR Q SCHOOL NAME AND ADDRESS (Street) (CIyY,) (State/CounTy) (IP) PHONE ADDRESS SOURCE q DL q Verbal q . OBTSNUMBER SPECIAL OPERATION -IDS NO DEFENDANT' S NAME (LAST FIRST MIDDLE) JAMES, GLORIA, MARIE DOB•(MMIDD/YYYI) AGE RACE SEX qHlspantc of Hispano 3 B F ETHNICITY 'AFRIC• SCARS TATTOOS UNIQUE PHYSICAL FEATURES (Location, Type Descephon) ['FELONY SMISD. ['TRAFFIC [WV . ODV ['MOVES OCIV IMF q IARRAM( 'FUGTRVE WARRANT q In stale .00ut of state I AGENCY CODE MUNICIPAL P.O DEF' ID NO MDPD RECORDS AND 'DAD STUDENT .1D NO 02 JAIL NO ALIAS and l or STREET NAME PMHD ®Yes ^No UNmown COURT CASE NO GANG ACTIVITY FRAUD RELATED RELATED ' ARREST ARREST SIGNAL: 0400 0150 0200 0300 0400 0.500 SOCIAL SECURITY NO ARREST TIME (IIHMM) 05:15 DRIVER'S LICENSE NUMBER /-STATE ARREST DATE (MMIDO/YYYY) 04/07/2011 GQ•DEFENDANT NAME (Last, FEE;, Middle) 1 CO•DEFEI4DANT NAME (Lest RraL Middle) 3 WEAPON SEIZED? Type q Yes XN0 II Del hae Concealed INDICATION OF Y N UNK Waapons•Pemilt Alcohol Influence X x q r, q PERMIT # W Drug Influence q ),a, q GRID C) O FELONY O q JUVENILE C 0 DV q MISDEMEANOR . q FELONY q JUVENILE q DV q MISDEMEANOR q FELONY 0 JUVENILÉ 0 DV” ^ q MiSDEMEANÓR DOB (MMIDDNWY) ARREST 'LOCATION (=ludo name of busmen) 4441 COLLINS AVE CITY OF MIAMI BEACH, FL 33140 Fountainbleau DOB (MM/DDNYYY•) 0.IN CUSTODY e q.AT LARGE CO-DEFENDANT NAME (Last, First, Middle) 2 q•IN CUSTODY q AT LARGE DOB (MMATDNYyY.) O.iN gt)8N•DY . 0 AT I,ARf3E, JUV only (Name) q' Párant q Guardian q Foster Cam •(SIMEE Apt Member) (City) (StetelCounhy) (MP) (Phone) Contsofed? Q Ye's .0 Na CHARGES CHARGE AS COUNTS FL STATUTE NUMBER VIOL OP SECT .CODE OF UCR 1 DV WARRANT TYPE OR TRAFFIC CITATION 1 SATTERYlSIMPLE IXF S D ow' 1 784.03 qAC ['CAPTAS qBW q FW DPW qJUV PU DAW qDVW' 0 WRIT CASE IA q FS Disorderly Intoxicaóp____ _856.01 qAC qCAPIAS DBW VFW DPW qJUV PU qAW qDVW ['WRIT CASE-#—.- 4 DAG DCAPIAS DEW OFVV DPW OAP PEI [JAW qOVW ['WRIT CASE P. DAC qCAPWS qBW qFW DPWqJW PU qAW qDVW' qWRIT CASE it The un nrargnad cerhfles and swears that he/she. has lust and reasonable grounds.tn believe. end does believe that the above named Defendant winmitted.the fob sang ;Ma tch of law od•ma 7 day et APRIL ; '2p 11 id 04:57. M,, i) a, 4441 COLLINS AVE FONTAINBLEAU (Nertaavo bdnpeafio) (Location,ataudename elbusinesa) IVIIAIVIItitAt.J:I-4 I WAS DISPATCHED TO THE ABOVE LOCATION REFERENCE A BATTERY ON A HOTEL EMPLOYEE. UPON ..__.___..._•.. ARRIVAL I MET WITH A VALET EMPLOYEE WHO 1•ASKED IF THEY HAD CALLED THE POLICE. I WAS THEN INFORMED BY THIS EMPLOYEE THAT A CO-WORKER WAS STRUCK IN THE FACE BY A FEMALE. WHEN ASKED WHERE WAS THE FEMALE HE POINTED TO A BLACK SUV WHICH WAS STATIONED ON THE VALET RAM!? AND WAS MOVING FORWARD ,4T1 ^INPTIÑG TO DRIVE ,4WAY. I THEN MADE CONTACT WITH THE DRIVER WHO IS A WHITE FEMALE AND WAS IN THE COMPANY OF A BLACK FEMALE WHO WAS'SftTING IN THE PASSENGER SEAT. I THEN ASKED THE FEMALE DRIVER TO EXPLAIN WHAT HAPPENED. THE DRIVER REMAINED SILENT AT WHICHTIME •I ASKED THE PASSENGER ' WHAT HAPPENED AND AGAIN GOT NO RESPONSE JUST A STARE. FINALLY.AFTER ASKING SEVERAL TIMES THE DRIVER STATED THAT SHE AND THE PASSENGER HAD A MINOR VERBAL ALTERCATION WITH THE VALET EMPLOYEE OVER HOW HE HANDLED THE PROCESS IN RETRIEVING .HER ••Iegasesbythis nill:eto appear mat may beheld contempt ef - ^` mwt•and a warrant ler•my psreit sla g be mend Fudhemmre, I• \ 79rea•thot nods oaneenlIng.Ne imp. data, end place of all cotm ^ ' haenngeahopldbesent to Me above address le. -ethat'll Is _ • are, my respintsibIl y to wit y Clerk of the Court (J notify Juvenile Dlvsmn)anyarga that my address anti Juvenile and Parent 0 3 0 FS q ORD q FS q r)RD 'Hamm . OUT 10flker:MuatAppear at Band 'Huang} Cuellar ^. 715 t 02 5./ COMPLAINANT'S SIGNATURE COl1RT ID NUMBEOLOC, CODE THAT THE•ABOVE STATEMENT. IS TRUE.AND CORRECT .. SWORN TO•AND $UBBGRIBED BEFORE E THE UNDE- GNEpA^l11.i0RTYTHI$: . DAYOF' ,r .^^ l^^ Y 1k ^) 82.02.09.9 Rev 04198 White Copy .X(lt. thlRTld pnn)

description

Gloria James complaint/arrest affidavit

Transcript of Gloria James

Page 1: Gloria James

COMPLAINT/ARREST AFFlDAViT ( -SCE CASE, NO

1 2011 .00039320

[

HEIGHT WEIGHT ' HAIR COLOR HAIR.LENGTH HAIR STYLE

EYES

GLASSES FACIAL HAIR TEETH

5 06140 ELK'MED BUS BLKPLACE OF BIRTH (Ciry Slete/Counlry)

USA.LOOM. ADDRESS (Street Apt Numhpr)

(City)

(Stale)

(ZIP)

PHONE

CITIZENSHIP

1168 KINGSRIDGE BLVD WADSWORTH, OH

USAPERMANENT ADORESS'(8lrael Apt Number)

q HOMELESS CI UNKNOWN

(City)

(Stale)Ceunlry)

(ZIP)

PHONE

OCCUPATION

OTHERq 'BUSINESS OR Q SCHOOL NAME AND ADDRESS (Street) (CIyY,) (State/CounTy) (IP) PHONE ADDRESS SOURCE q DL

q Verbal q .

OBTSNUMBER

SPECIALOPERATION

-IDS NO

DEFENDANT'S NAME (LAST FIRST MIDDLE)

JAMES, GLORIA, MARIEDOB•(MMIDD/YYYI)

AGE

RACE

SEX

qHlspantc

of Hispano

3

B FETHNICITY'AFRIC•SCARS TATTOOS UNIQUE PHYSICAL FEATURES (Location, Type Descephon)

['FELONY SMISD. ['TRAFFIC [WV. ODV ['MOVES OCIV IMF

q IARRAM( 'FUGTRVE WARRANT q In stale .00ut of state

I AGENCY CODE MUNICIPAL P.O DEF' ID NO

MDPD RECORDS AND 'DAD

STUDENT .1D NO

02

JAIL NO

ALIAS and l or STREET NAME

PMHD®Yes ^No

UNmown

COURT CASE NO

GANG ACTIVITY FRAUDRELATED

RELATED 'ARREST

ARREST

SIGNAL:0400 0150 02000300 0400 0.500

SOCIAL SECURITY NO

ARREST TIME (IIHMM)

05:15

DRIVER'S LICENSE NUMBER /-STATE

ARREST DATE (MMIDO/YYYY)

04/07/2011GQ•DEFENDANT NAME (Last, FEE;, Middle)

1

CO•DEFEI4DANT NAME (Lest RraL Middle)

3

WEAPON SEIZED? Typeq Yes

XN0

II Del hae Concealed

INDICATION OF Y N UNKWaapons•Pemilt

Alcohol Influence X xqr,

q

PERMIT # W

Drug Influence

q ),a, qGRID

C)

O FELONYO

q

JUVENILE C0 DV q

MISDEMEANOR .

q

FELONY q

JUVENILEq

DV q

MISDEMEANOR

q

FELONY 0 JUVENILÉ0 DV”

^ q

MiSDEMEANÓRDOB (MMIDDNWY)

ARREST 'LOCATION (=ludo name of busmen)

4441 COLLINS AVE CITY OF MIAMI BEACH, FL 33140 FountainbleauDOB (MM/DDNYYY•) 0.IN CUSTODY

e q .AT LARGE

CO-DEFENDANT NAME (Last, First, Middle)

2

q •IN CUSTODYq AT LARGE

DOB (MMATDNYyY.)

O.iN gt)8N•DY .0 AT I,ARf3E,

JUVonly

(Name)q 'Párantq Guardianq Foster Cam

•(SIMEE Apt Member)

(City)

(StetelCounhy)

(MP)

(Phone)

Contsofed?Q Ye's.0 Na

CHARGES CHARGE AS COUNTS FL STATUTE NUMBER VIOL OP SECT .CODE OF UCR 1 DV WARRANT TYPE OR TRAFFIC CITATION

1 SATTERYlSIMPLEIXF SD ow' 1 784.03

qAC ['CAPTAS qBW qFW DPW qJUV PU DAWqDVW' 0 WRITCASE IA

q FSDisorderly Intoxicaóp____ _856.01

qAC qCAPIAS DBW VFW DPW qJUV PU qAWqDVW ['WRITCASE-#— .-

4

DAG DCAPIAS DEW OFVV DPW OAP PEI [JAWqOVW ['WRITCASE P.DAC qCAPWS qBW qFW DPWqJW PU qAWqDVW'qWRITCASE it

The un nrargnad cerhfles and swears that he/she. has lust and reasonable grounds.tn believe. end does believe that the above named Defendant winmitted.the fob sang ;Ma tch of law

od•ma 7 day et APRIL ; '2p 11

id 04:57.

„M,,i) • a, 4441 COLLINS AVE FONTAINBLEAU

(Nertaavo bdnpeafio)(Location,ataudename elbusinesa)IVIIAIVIItitAt.J:I-4

I WAS DISPATCHED TO THE ABOVE LOCATION REFERENCE A BATTERY ON A HOTEL EMPLOYEE. UPON ..__.___..._•..

ARRIVAL I MET WITH A VALET EMPLOYEE WHO 1•ASKED IF THEY HAD CALLED THE POLICE. I WAS THENINFORMED BY THIS EMPLOYEE THAT A CO-WORKER WAS STRUCK IN THE FACE BY A FEMALE. WHEN ASKEDWHERE WAS THE FEMALE HE POINTED TO A BLACK SUV WHICH WAS STATIONED ON THE VALET RAM!? ANDWAS MOVING FORWARD ,4T1 ^INPTIÑG TO DRIVE ,4WAY. I THEN MADE CONTACT WITH THE DRIVER WHO IS AWHITE FEMALE AND WAS IN THE COMPANY OF A BLACK FEMALE WHO WAS'SftTING IN THE PASSENGERSEAT. I THEN ASKED THE FEMALE DRIVER TO EXPLAIN WHAT HAPPENED. THE DRIVER REMAINED SILENT ATWHICHTIME •I ASKED THE PASSENGER ' WHAT HAPPENED AND AGAIN GOT NO RESPONSE JUST A STARE.FINALLY.AFTER ASKING SEVERAL TIMES THE DRIVER STATED THAT SHE AND THE PASSENGER HAD A MINORVERBAL ALTERCATION WITH THE VALET EMPLOYEE OVER HOW HE HANDLED THE PROCESS IN RETRIEVING.HER

••Iegasesbythis nill:eto appear mat may beheld contempt ef

- ^`mwt•and a warrant ler•my psreit sla g be mend Fudhemmre, I•

\79rea•thot nods oaneenlIng.Ne imp. data, end place of all cotm

^ 'haenngeahopldbesent to Me above address le. -ethat'll Is _ • are,my respintsibIl y to wit y Clerk of the Court (J

notifyJuvenile Dlvsmn)anyarga that my address

anti Juvenile and Parent 0

3

0 FSq ORD

q FSq r)RD

'Hamm . OUT 10flker:MuatAppear at Band 'Huang}

Cuellar

^. 715 t 025./ COMPLAINANT'S SIGNATURE

COl1RT ID NUMBEOLOC, CODE

THAT THE•ABOVE STATEMENT. IS TRUE.AND CORRECT .. SWORN TO•AND $UBBGRIBED BEFORE E

THE UNDE- GNEpA^l11.i0RTYTHI$: .

DAYOF'

,r .^^

l^^ • Y 1k

^)

82.02.09.9 Rev 04198 White Copy .X(lt. thlRTld pnn)

Page 2: Gloria James

DFFENDANTS.NAME (LAST .FIST MiDDE)

JAMES, GLORIA MARIE.

.DOB-(MM/DO/YYYY):

ADDET(9NAL CO-DEFENDANT NAIRE (I.adl. First Middle). DOB (MMIDD/YYy1) q 'IN CUSTODY q FS.OtJY q Jl .NENII.E4 :d AT L'I(RGÉ

tj'D!)• . '.q MISDEMEANOR

ADDITIONAL PO-DEPENDAN TAME (Last PY t. Middle) . DOB (MM/DDNYYYI q ,s CUS¡'OW q 'FELONY ( q JUVENILE

E

. q

AT LARGE 17 DV q MISDEMEANOR

AODITIONAL:CHARGPS CHARGE AS COUNTS

FL STATUTE NUMBER VIOL OF SECT

CODE OF

CR DV

WARRANT TYPE OR TRAFFIC CITATION'qAC qCAPIAB qBW qFW qPW qJW PU qAWqDVW qWWTCASEikqAC OCAPLIS qBW q FIyLIPW qJW PU qAWqDVW qWRrTCASE *

q F.S

q

ORO

qAC q OAPIAS qEW qFW L9PWRJW P13 qAW^l)VW qLVRrr

.....CASE tk Zq

FSqAC qCAPIAS qBW OFW q PW qJU•v PU CJAW c

q

OROq fWW qWRR•CASE t7.

--I

VEHICLE. SHE ALSO STATED THAT HER FRIEND-THE ARRESTEE AND THE VALET EMPLOYEE GOT UP INTO'-EACH..pTHERS FACES OVER THE INCIDENT. I THEN MADE CONTACT WITH THE VALET EMPLOYEE(VICTIM) WHO'STATED THAT HE: BROUGHT THE VEHICLE TO THE VALET RAMRAT THE REQUEST OF THEARRESTEE..HE THEN DROVE.UP.WITH THE VEHICLE AS THE ARRESTEE STOOD OUTSIDE TALKING TO'OTHER PATRONS OF THE HOTEL. -THE VALET EMPLOYEE STATED HE WAITED FOR 30 MINUTES AND THEARRESTEE WOULD NOT GET HER VEHIC-.LE: FINAL•LYHE-TU .•NED OFF THE VEHICLE WHICH WAS STILL ON'

'-THE•VALET RAMP AND GAVE THE KEYS'TO THE'VALET• CASHIER. AFTER A SHORT WHILE ACCORDING TO'THE-VICTIM AND WITNESSES THEARRESTEE CONFRONTED THE VALET EMPLOYEE AND STATED WHERE 'ARE MY FUCKING. KEYS AND CONTINUED YELLING PROFANITIES AT THE VICTIM. ALL THE WHILE THEVICTIM TRIED TO EXPLAIN TO THE ARRESTEE THAT HE WAITED FOR HER FOR 30 MINUTES BUT : COULDNOT WAIT ANY - LONGER. THEN FOR NO APPARENT REASON THE ARRESTEE STRUCK THE VICTIM WITHAN OPEN HAD ACROSS THE RIGHT SIDE OF HIS_FACE AND IN THE PROCESS CAUSING HERSELF . TO LOSEHER BALANCE AND FALLING TO THE GROUND. I THEN WENT BACK OVER TO THE ARRESTEE WHICH BY

-THIS-TIM E-WXSOUTSIDETHE VEHICLE AND XSKED F1 R -FURBER IDEÑTIFI ATIOÑ_TF E-AqRE-STEE THÉÑREFUSED TO PROVIDE HER IDENTIFICATION AND STATED "NOW YOU WANT MY I.D. BUT AGAIN WOULDNOT PROVIDE IT. I THEN PLACED THE ARRESTEE UNDER ARREST AT WHICH TIME SHE BEGAN TO YELLAT THE OTHER FEMALE'W'HO. WAS THE DRIVER" DON'T GIVE HIM ANYTHING,DON'T GIVE HIM-MY PURSE.ALARGE CROWD THEN GATHERED IN FRONT OF THE HOTEL CAUSING VEHICLES TO BACKUP ON THEDRIVEWAY. THE ARRESTEE ALSO HAD BLOODSHOT EYES AND A STRONG ODOR OF ALCOHOL ON HERBREATH. AFTER THE ARRESTEE WAS PLACED INTO MY PATROL

^ ^in8oqtl Ttpe(Inq)•

SWORN Tp1tJAD. fiUB.SOk;IBED BEFQI;E

Tli^ Ut•{> ,' SIOIJ.Qi' .. • OR^'1T'ÍI9íí

^ ,̂

^

ma _,1t

SWEAR THAT•TREABOVE 87ATE

(

M

4

E T IS•TRUE••AND CORRECT

p

^,^,! ^s 715 (02 ).9 E

Q91APUIWANP9 SIGNQT)JRE

'CQU}.. ID:NUMBER/LOQ' CODE '

Cuellar MIAMI BEACHNAME (Printed)

:AGENCY NAME

•82•Q2.Q9;9 Rov 0570B

Deputyot)ha dpr .Notatyi

bLD 4

J/11f...NO•

IDS NO.

OETS'NUMBER

AGENCY CODE

02

.COURT CASE NO

q FS

COMPLAINT/ARREST AFFIDAVIT^0E‘1TINUAPION . ......."

MUNICIPAL P.O , DFx ID NO MDPD RECORDS AND ID, NO

POLICE CASE NO

22011-00039320'

w.,

[] FS

`jq oRo

><

0

that Lmay do' held dn wntampt of court and a Normalfófmy árá(shill bé,reettbd purthome:tagree that Hoban eaneemng the lime, dalá,add plpde"bf ell ehiat•h^rujpá.ehodltl.t>a, eent to•lhe,

,above.addreas.J agree that 8 ts.my.reapár Ib)fty le nbtlry C pf lhe•Cáah(JUyeMlaa npt(ry.N canto DneDn) anylMa trial niyetldreae ehangas.

Yod need' not appeerjai bo buj r epiufmmpl7 wetrfhd (nsatillólis pn (Ita.royee a itle h'az !

Arrest Report 2011-00039320 Page 7 OF 12

Page 3: Gloria James

^QIMPLAINT/ARREST.CONTINLIATIQN

mGSNOYCCD:

02

MUNICIPAL Kn

mho4q

^

COURT DASE NO

WD mEDORD.S-AN616 NO

- 2.0114)0039320'n~

-^w wu^m^,^

COUNTS

JAMES, GLORIA MARIEADDIT03NAL CODEFENDANT NAME (LT!, Fast Mcddk

4'

ADDMONAL CHARGES.

Do]3.(Mm/r)weym

zx- lNm*STQDY oFumNY o-4LJ,ENILEAT LARGE .O Dv

II 'MISDEMEANOR

ow Cqvmu

FE omy 13 JLJWNl[X,

CI AT LARGE CI DV

Cl MISDEMEANOR

Dv

WARRANT TYPE OR.TRAPPIC CITATION

MAIL M0AP/0W bM MM =, 0 MAW

CASE m

-I;IAC oCAPIAS CISly PFW.ppkPuW PU P*M" Mm

OCApIA3

AWN,

oPW o44mc AWmbVw WRIT

MAC 0CAPIAS 'MBW OT My M, N 0AVV

'CASE'S

mm

FL STATUTE NUMBER VIOL. Of SECT CODE OF wm

VEHICLE AT WHICH TIME |WAS APPROACHED BY SEVERAL SECURITY EMPLOYEES OF THE HOTELDVIS (kIG ME THAT THE ARRESTEE IS LABRON JAMES MOTHER. /THEN ADVISED THE SUPERVISOR SGT.

SANWEZANO AFTER.08l7\NKÚ G STATEMENTS FROM TWO VALET CASHIERS WHO ALSO WITNESSED THEBATTERY THE ARRESTEE WAS TRANSPORTED TOTHESTATION. WHILE ATTHESTATION SGT. ROJO AND

HESHIFT-COMMANDER [[ACOGTATRIED TO SPEAK WITH THE ARRESTEE WHO WAS THEN VERY'IDUNCOOPERATIVE 8T/Q

'|NG !T1NTRY(NG TO TRUST-YOU BUT|8DN7 TRUST'YOUR

HAT OFFICER WHO ARRESTED ME. ARRESTEE STATED THAT SHEKNEW OUR PROCEDURESTAAS-yVOT GOING TDCOOPERATE BECAUSE SHE DID NOTHING WRONG. ARR ESTEEWOULD NOT ALLOW

CRIME SCENE TO TAKE PHOTOS OF HER AND REQUESTED &PHONE CALL. ARRESTEE WAS THEN ISSUED APROMISE TO APPEAR AND RELEASED TO MIAMI HEAT EXECUTIVE MR. STEVE STOWE.^

.

.

^

'

-

,

,D HOLD FOR BOSD HOSING DO NOT SOND'

_ ' ASOVh STATEMENLIS .TRUE AND CORRECT'_

.---_^"^- -,^n~~/ .'^p^ ^ "'^=^^r^~—

715

u 02 p/vm"N "=="m R^^m

-.P

DR

OPPRIY orP34

g, NO.AGENCY.NAME F

132.42,M Rsv:0&06

White Copy

=(LddM,I-8gm6'M%Ls;my

n0tIfY AN='& =an) anytime that my,4#*ppupor,

'You *ded'notapped

ant '•IiNrrle 4r!;t pa.rdg,or (3.

.^.

wp

^

0lJC .

Arrest Supplement Report 2011-00039320 Page 1 OF 12

Page 4: Gloria James

OFFICER NAME

Evidence D1st/Section 1.M No. Phone

U'ltd

( N

(- ^

• . C

Officer Information ° ^•^,^_ ^ g 3 t-•o

Evidence DisVSeotlon I.D. No. PhoneConfiscated

(Y/N)

70

Cell

Pager

Shift (Days OH/Duly Hrs.)

M

-rl`n

0O

rDz

qLEAD DRESPONDING DARRESTIÑG qTRANSPORTING

DUI ONLY: q(W) D(RS) q (B) q (M) q (MW) q (IC) q (ICW) q (BAFF) D(BAPFW) q (DRE) q (20M]NOBS)

q AD qRBSPONDING DARRESTING qTRANSPORTFNG DUI ONLY: D(W) D(RS) q(B) q (M) q (MW) D(IC) D(ICW) D(BAPF) D(BAFFW) D(DRE) D(20MINQBS)

: (2) D DCF contacted; (3)

list all child witnesses col

(Sex)

(Date of Birth)

OTHER PHONE #'S O

1PONNIMLPgr m.

Wrk .

Synopsis of Testimony:

finS;

TNESS DOWNER' FOR'DV ONLY:' (1) Relationship to defendant: (2) : DCF contacted; (3j *""I)sfall 'child witnesses

ame (Last)

.. '

(First)

a

(Middle)

(Race)

Business or ^thér Address

Address Source: OVerbal q Driver's License Voter's 1.D.0 Other D.L.#

Synopsis of Testimony:

ICTIM

WITNESS DOWNER FOR DV ONLY: ' (1) Relationship to defendant: : (2) D DCF contacted; (3) ***list all child witnesses

(First)

(Middle

ICTIM DWITNESS DOWNER FOR DV ONLY: (1) Relationship to defendant:

otiaedt1-•r . Sb i(Middle(First)

IEEE:(City)

(State)

(Zip) (Phone)

Business or Other Address

(City)

(State)

Address Sóurce: OVerbal ODriver's License OVoter's I.D.0 Other

(Phbne)

D.L.#

, Wrk

ti

me Laste

Race)

(Sex) (Da of Birth)

OTHER PHONE #'S'me Address (Street, A • (City)

(State) ''

p

(Phone)

Business or Other Address

(City)

(State)

(Zip)

(Phone)

Address Source: O Verbal Driver's License :Voter's I.D.q Other D.L.#

Cell

Pgr

Wrk

.Synopsis of Testimony:

DVICTIM WITNESS DOWNER FOR DV ONLY: (1) Relationship to defendant:

GM(LA'a-LIN

eLast t

: (2) DDCF contacted; (3) ***list' all child witnesses

Race (Sez)

(Date of Birth)

OTHER PHONE #'SHome Address (Street,.Apt. um one) .(City)

ry]

Wrk

Cualtieaa ui QuMci Auu!ebb

(c ny)

tatme)

ip)

truu

Addresq,,5fil,trc

Verb

Drlver's License I-iVoter's I.D.i-(Other

Synopsis of Testimony: •