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_COURT CASE/
CRIMINAL REPORT AFFIDAVIT /
GRID # _S_____
J.F. ID # SAO # OBTS # ApREST
yProbable Cause A-Adult
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AGENCY REPORT # ILO
AGENCY NAME ORI # El Capias
4,110 'M
El Juvenile
0 Fugitive Warrant 0 Delinquency
C2.-902-
2
05 GEs ?)cc\.tx.) Gi- 01:1 WVOaPrrNan?
LOCATION DATE OF f--- ) ) TIME OF CC 0 Dependency

cc
I-
OFFENSE

WITHIN:
OFFENSE ( 1 i f- OFFENSE CS:32
El Juvenile Pickup Misdemeanor
El Traffic MISD
%Felony
0
(f)
E TAMPA PLANT CITY El TEMPLE TERRACE 0 UNINCORPORATED AREA O SUPPLEMENTAL CRA ATTACHED 0 REQUEST FOR:
0 Traffic FEL
El Direct File/SAO
cq COURT:
Review
0 Ordinance
< TAMPA COURT PLANT CITY CT 0
li 0 Warrant
0 Pickup
0 Other
El Summons
CSVMS (kwi-bn
LOCATION ,.., DATE OF TIME OF
ARREST LA r ARREST G
,-.).
-1 ARREST 1/4-7-17 0 Juvenile Pickup 2.,(:). p p,mi_Lis-
BOOKING #
I ra,pin Lq._
I 4I.)%,
kift
%., 136 SOID #0 00B61M%{TYPE ( WEAPON hi WEAPON
SEIZED Yes 0 Nolif
0 Arresting officer

officer.
,-- 0 Booking supervising

NAME
RACE:
SC3eFa("-st Co\ ,t--- L...
U4INT First Middle
ALIAS
COMPLEXION BUILD
W-Wh..
.ite I-American liSikn/Alaskan
Nates, HI:kitsanisp1.1B Hispanic Black
HEIGHT(QfAi WEIGHT'
B-Black 0-Oriental/Asian a
RaceLtsi_ SEX I 1 1 D.O.B. k.."A
.-
-''''
-

mo / DAY / YEAR APPROXIMATE AGE COLOR: EYES HAI -410"--

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LOCAL ADDRESS (Street, Apt. #, City, State, Zip) ''") IC)CM V UM Ph #:

Permanent Address (Street, Apt. #, City, State, Zip) I12 Ph #:

Business Address (Street Apt. #, City, State, Zip) Ph #:

NDorh5tre. t ri :36, 1.s. c-.) State a.- T F04

0
DOC #

Gang Member: Yes 0 No / Gang Name

NoldC
SCARS, MARKS, TATOOS,
UNIQUE FEATURES (Loc., Type, Desc.)
IF JUVENILE:
School Name
Mother/Guardian Address Ph #:
Father/Guardian Address Ph V C-3
e---
Released To: JAC 0 Parent 0 Guardian 0 Other Relationship 0 kWJther ....4 rrl
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4... ..,
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gl
.7,..
Friaie..
DArrested
Co-Defendant (Last, First, Middle Sex:
0 INa
Felony Misdeure4ew At Large 0 Capias/Warrant Requested O E .. ..
0
tivrtle El
Co-Defendant (Last, First, Middle Sex: Raes:',,-;;' DOB
-__-] (--
Arrested 0 At Large E Capias/Warrant Requested 0 Felony 0 Misderrikaioi El
.
3 TuVenile 0
-C>

STATUTE (subsec ) / ORD # DV CP

CHARGE
STATUS
BOND
SET
CHARGE r-1FFIC --4(4.,)
CIWION #
;MUG
AG-TITYPE

/-Piarmck N t) GAvor opcxximir'N-

i- . F-6 V`K:15
(i :?E34.0446(3) tI 14,1 fONOre,6
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9 6
CY: sE30 v.) 14 C2- -TrillZakS GOOCk\Of>

.441
CHARGE STATUS: F-Felony M-Misdemeanor T-Traffic 0-Ordinance FT-Felony Traffic DV-Domestic Violence CP-Child Present
ACTIVITY: N-N/A P-Possess S-Sell B-Buy T-Traffic R-Smuggle D-Deliver E-Use K-Dispense/Distribute M-Manufacture/Produce/Cultivate Z-Other
Type: N-N/A A-Amphetamine B-Barbiturate C-Cocaine E-Heroin H-Hallucinogen M-Marijuana 0-Opium/Deriv. P-Paraphemalia/Equipment S-Synthetic U-Unknown Z-Other

I--
ce A LIST OF TANGIBLE EVIDENCE (If none, write "None") (Evidence List must be provided for all NOTICES TO APPEAR)
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CC I.I.J
DESCRIPTION/AMOUNT PER UNIT RECOVERED BY GIVEN TO PRESENT LOCATION
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(:)ee PItc)SCA"
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1
2
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1.1.1

'2
Mandatory Appearance in Court 0ou need not appear in Court, but must comply with instructions on Reverse Side. 0

COURT INFORMATION: You must appear in County Court at the:

M COURTHOUSE TOWER ANNEX, 801 E. TWIGGS STREET E COUNTY OFFICE BUILDING, MICHIGAN & REYNOLDS STREET 0
<
U.1 (Corner of Jefferson & Twiggs Street), TAMPA, FLORIDA 3360 PLANT CITY, FLORIDA 33566
Division

COURTROOM #
"

cL. ON ,20, AT a.m. CI p.m. 0

iti <
2 I agree to appear at the time and place designated above to answer for the offense(s) charged or to pay the fine subscribed. I understand that if I willfully fail to
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appear before
z the Court as required by the I may be held in contempt of Court and a warrant for my arrest shall be issued. You may also be charged with the crime of
ui
- 0 Failure to Appear, F.S. 843.15. I certify that my address as listed above is correct and I further understand that I have a continuing duty to advise the Court of any changes
1..)
z 1= in my address as set forth above.
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(.5 z Signature of Defendant/Juvenile Parent or Guardian (It kiwi*
4
tAlkir. rin.4.,-.4 r-,,,, 1 rl flreuan C tot. A iftsrne.,
Akocie*Ist-A- 5eicb. 9*.k5-\6s c),0A \s\clao vk.Orty)
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f4,1oect.. .

Judgemenlasqupstjed am!nst defendant for agency investigative cost per Florida Statute 938.27: $
OFFICER %5(ZY POLICE REPORT WRITTEN: Yes No [3
l.D. # Dist. &
'(Please Print The Al5ove Information)
Squad MCRAC4W2. OFFICERSA-314,1M1 I.D. # /0
Dist. &
Squad DtA
I SWEAR THAT THE ABOVE STATEMENTS ARE CORRECT TO THE BEST OF MY
SWORN TO AND SUBSCRIBED BEFORE ME THIS KNOWLEDGE. FOR NOTICES TO APPEAR, I ALSO CERTIFY THAT A COMPLETE
9t1 DAY OF Ftr 641d, 20 (-7 LIST OF WITNES S AND EVIDENCE KNOWN TO ME IS ATTACHED.

5/40g-totz eZ &ill e eryvp."-- AFF)ANT, signature

Fi LL
NAME/Tide of Person Authorized to Administer 0

AFFIANT Putt/Type Name 4

CLERK OF COURT SAO FORM-425. 10/03

 Use Ballpoint Pen
Press Firmly

COURT CASE /
sta:Th,
AkaAVIT EMENTAL CRIMINAL REPORT
ORIGINAL CRA # It 1 Cq LI
IF. ID # SAO # OBTS #
a 2-
Ca-402
PAGE OF
AGENCY REPORT # KO a4"0"481
'
AGENCY NAME \ efINVOr 0R, #

cx,e c-/ A
TIME OF
OLOFFCEANTISOEN
DATE OF
OFFENSE --A .t OFFENSE cimc.i
WITHINA
TAMPA Or PLANT CITY CI TEMPLE TERRACE CI UNINCORPORATED AREA 0
COURT:
TAMPA COURT Et PLANT CITY CT 0 BOOKING # 111) O (:) 9-3C SOID # ARREST DATE
0
a.
ill NAME
-

v
- -
116 . ALIAS
cc Last First Middle
RACE:

JMc)
748-Hispanic
B-Black 0-Oriental/Asian
W-Wh._
kite I-American Indian/Alaskan Naty,,p,. anc Black
SEXY.NA
1 Racek. /
D.O.B. '''A i U'.
/ DAY / YEAR APPROXIMATE AGE

SZaTUTE (subsec.) DV CP CHARGE BOND

CHARGE
TRAFFIC DRUG
/ ORTY-0..._ STATUS SET
ACT/TYPE,
CITATION #

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0
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CHARGE STATUS: F-Felony M-Misdemeanor T-Traffic 0-Ordinance FT-Felony Traffic 13Iset
DV-Domestic Violence CP-ChildC?
ACTIVITY: N-N/A P-Possess S-Sell B-Buy T-Traffic R-Smuggle D-DeliverK-Dispense/Distribute M-Man4claffle/ProdudetCultivatsiZZ-Other
E-Use
TYPE: N-N/A A-Amphetamine B-Barbiturate C-Cocaine E-Heroin H-Hallucinogen M-Marijuana 0-Opium/Deny. P-Paraphernalia/EquiPhie-SyntheffAJ-UnkriNn Z-Other
n e

Co-Defendant (Last, First, Middle) Sex: Race: DOB

Arrested 0 At Large 0 Capias/Warrant Requested 0 Felony 0 Misdemeanor 0 Juvenile 0

Co-Defendant (Last, First, Middle) Sex: Race: DOB

Arrested 0 At Large 0 Capias/Warrant Requested 0 Felony 0 Misdemeanor 0 Juvenile 0

A LISI2E3ANGIBLE EVIDENCE (If none, wnte "None") (Evidence List must be provided for all NOTICES TO APPEAR)
DESCRIPTI
k "ER UNIT RECOVERED BY GIVEN TO PRESENT LOCATION

Additional facts to establish probable cause that a crime was committed by the defendant or that the child is dependent Cht.\ 2 -

_ _ _ _

Ui \ _

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The above additional facts were sworn to on the second page of the original Criminal Report Affidavit.