Department af Police Service CITY OF KINGSTON, NEW YORK CCARRAGHAN ORE HEMISSTON 1201 GERALO M, KELLER fees 2007 ‘HOF POUE USE OF TASER SUPERVISORY REPORT To be completed by the supervisor of the officer deploying Advanced TASER X26 Deploying Officer's Name:_™, Mts Bodget_228 Tour: 8 Date of incident a]usfus°_Time:yo 1. Caseks 204s -tbISe. Aresty_2O1S- 1927 Subjects Name:_Fabiew C. Mansiee vos:_2)s Ise Charges: Discreet Comore Resisnoe Maeest Nahi) Res of Mereayene Location of incident, FO QeureaA-Cemrer Marner bw & Mwy Ave Device Serial Number. YOU-SO 1470, Associated Blotter Number: 2ois —1g#5% Nature of call; Possible Asseu0A Time of TASER Deployment: 104 Time Supervisor Notified: yo 4 Did you respond tothe scene? Yes] No ‘Were there injuries to any police officers? Wres CO No Explain: GFfuer ARaveno soll MH Commision aud May fo bus O) eye é ar abcasums ‘Were thers any injuries to clvllans, bystanders or.uninvolved parties? [] Yes (fo Explain ‘Were other methods of force used or attempted prior to TASER Deployment?:. Yes C]No. tes, Explain_Veabal Awecno® physcat_gegmaut Was the TASER etfectva?: Ares No Comments:. — Did the subject immediataly comply? CT Yes (Wf No iyeeenares Siete ewe es My anaes vel mes to ares ules pases — Gece AS "bid the TASER application cause injury? Oye No Description of Injuries: Accredited Agency hh No ST P BuwroBepartment of Police Sernice CITY OF KINGSTON, NEW YORK = GARRAGHAN ORIVE KINGSTON, WY (2001 (a4) 30-1871 GERALD M, KELLER, ‘CHIEF OF POLICE USE OF TASER SUPERVISORY REPORT To be completed by the supervisor of the officer deploying Advanced TASER X26 Deploying-Officer’s Namex_™), Ms Ns. Badget_228. Tour 8-4 Date of Incident_@ 4/3” Time:(0:4 Case: 2018-(8#S2 Arrest: 2O1S~ 102? Subject's Name:__Fabieu C. Marswace p00:_2)s Ig Charges: _Discpsealy Cowoucr Resumac Aceest Yoluah] Rose of Mereyuave Location of Incident: $50 Resst-A-Covrer Mares bir 4 Muy Moe Device Serial Number, XOO-SO1G70. Associated Blotter Number:_2ois ~16#5% Nature of catt__fossible Assanld Time of TASER Deployment:_104Y Time Supervisor Notified: Jo 44 Did you respond to the scone? Yes No Were there injuries to any police officers? MYes ONo Sxplain: OFFcer RAcrero sored a commsion ond swelling fobs O) eye. well a vam altesions Were there any injuries to civilians, bystanders or uninvolved parties?’ (Cl Yes [No Explain: Were other methods of force used or altempled prior to TASER Depioyment?:, Yes No UtYes, Explain_veabal dveccnos, physicoe gegmaur Was the TASER effective?: Hes CINo Comments: Did the subject immediately comply? Cl Yes Wf No He ommansen Gombanve unt Explain:_y. was dy smeven sevent mes avo waspeulli vad ye Weare at HO No " Did the TASER application cause injury? Ces Description of injuries: Accrediten Agency he No STP. Beare‘Suspect Description age:__2S_ see Height G0" race:_& _euiis:_4 ©? Was the suspect wearing heavy clothing? Dyes No ‘Actual TASER Application: [Ate Display [] TASER Blisplay CJ TASER Use Aon use Is this a dart probe contact? Ove [No i ‘Approximate target distance,at time of dart launch, Dawe swe ‘Additonal shots needed? (Number) Ves CI) No Did dart contacts penetrate the subject's skin? Dyes (Wo isthe subject request further medical attention?” §—C] Yes CW “IT'S eae allen te HG Did the device function satisfactorily? es No APPLICATION AREAS — All Points of Contact (please indicate on diagram with contact typ ews Notes? © Yes [No Darts removed by EMS? Wh aves cio : EMS Service: _4E'D Time Notified; ____ On Scene: Name of EMT? Paramedic removing darts pl __ ‘Subject Transported to Hospital? ves PN6 Time: Transported by: sla Unite_esla_ Hospitat pla Attending Physic: __ admited? . ClYes No. {admitted to hospital, reason for admission: ple (COMHL9.41 C1 Injuries from TASER [1 Injuries from other:‘Summary of Interview: nie Was the subject under the influence of drugs or alcohol? Ores Cfo Specify: __ Were you present atthe time of TASER Deployment? Ores no Description of the subject's demeanor prior to application of TASER: Combanve Description of the subject's demeanor after the device was used or displayed everually conglust ‘Check any additional means of control reported or attempted: CO.C. Spray [) Baton or Blunt Instrument [Hand ‘Techniques or Control Holds Photographs Secured? [Yes C] No Photogrepher:__ Ryans Notifications made, if any: deputy chiet patertime: 24 [ey iis Cl chier of Potice: Datertime: Witnesses: Name: win op: Phone: Address: Name: Address: eee ‘Other Witnesses? Yes 0) No(ityes, tist in supplomentavcase report) Results of investigation: EA TASER Use Justified and in compliance with department policy CUTASER Use questionable ~ Internat investigation indicated CT] Unknown at tine of report — Investigation Ongoing ‘Signature of Reporting Supervisor: 142. oate:_ale his Date: hl Signature of Deputy Chief: