Incident Report

Incident Report

Midtown Police Department

Incident #: RB-05-14-12-5234 Incident Status: Cleared By Arrest

Report Type: Initial Report Arresting Officer: Terry Schield__

Complainant: (Last, First, Middle) Marquette, Speedy Racer /Phone #: (260) 555-1234

Address: 3050 Heartland Street Apt.# 304 Midtown, Minnesota 56464______________

Location of Incident: 100 South Main Street Midtown, Minnesota 56464___________

UCR Offense Code: 220 Date(s) of Incident: 05-14-12 _____________________

Time(s) of Incident: Between 12:00 AM and 12:25 AM__________________________

Offense: 1. Burglary 2. Breaking and Entering_ Offender: Ronald Riff__________

Bias Motivation: None___________________________________________________

Bias Motivation Codes:

Racial Religious ____________ __

11. Anti-White 21. Anti-Jewish

12. Anti-Black 22. Anti-Catholic

13. American Indian 23. Anti-Protestant

14. Alaskan Native 24. Anti-Islamic (Moslem)

15. Anti-Asian/Pacific Islander 25. Anti-Other Religion

16. Anti-Multi Racial Group 26. Anti-Multi-Religious Group

27. Anti-Atheism/Agnosticism

Sexual Ethnicity/National Origin___________

41. Anti-Male Homosexual (Gay) 31. Anti-Arab

42. Anti-Female Homosexual (Lesbian) 32. Anti-Hispanic

43. Anti-Homosexual (Gays and Lesbians) 33. Anti-Other Ethnicity/National Origin

44. Anti-Heterosexual

45. Bisexual

Enter Bias Motivation Code If Different From Offense #1

#2 Non Applicable

#3 Non Applicable

Offense Status: (Check only one per status)

1. A-Attempted 2. A-Attempted 3. A-Attempted

C-Complete√ C-Complete√ C-Complete

Offender(s) Used: (Check As Many As Apply)_______________________________

A. Alcohol C. Computer Equipment

D. Drugs N. Non Applicable -√

For Burglary Only:______________________________________________________

Number of Premises Entered: 1______Entry Method: F-Forcible√ N-No Force_

Location of Offense: (Check only one) (enter Code Number For Offense #2___#3__)

01-Air/Bus/Train Terminal 04-Church/Synagogue/Temple 07-Convenience Store

02-Bank/Savings and Loan 05-Commercial/Office Building 08-Department Store

03-Bar/Night Club 06-Construction Site 09-Drug Store

10-Dr's Office/Hospital 15-Hotel/Motel/Etc 20-Rental/Storage Facility

11-Government/Public Buildings 16-Jail/Prison 21-Residence/Home

12-Field/Woods 17-Lake/Waterway 22-Resturant

13-Grocery/Super Market √ 18-Liquor Store 23-School/College

14-Highway/Road/Alley 19-Parking Lot/Garage 24-Specialty Store (TV)

Type Criminal Activity: (Check up To Three)________________________________

B-Buying/Receiving O-Operating/Promoting/Assisting

C-Cultivating/Manufacturing/Publishing P-Possessing/Concealing

D-Distributing/Selling T-Transporting/Transmitting/Importing

E-Exploiting Children U-Using/Consuming

Type Weapon/Force Involved:_(Check Up To Three) (Enter A In Box If Automatic)___

11-Firearm 30-Blunt Object 65-Fire/Incendiary 99-None

13-Rifle 35-Motor Vehicle 70-Narcotics/Drugs

12-Handgun 40-Personal Weapons 85-Asphyxiation

14-Shotgun 50-Poison 90-Other √ Hammer

15-Other Firearm 60-Explosives 95-Unknown

20-Knife/Cutting Instrument

Victim(s)______________________________________________________________

Victim #1: (Last, First, Middle)_Marquette, Speedy Racer /Phone: (260) 555-1234___

Address: 3050 Heartland Street Apt.# 304 Midtown, Minnesota 56464_____________

Race: White Sex: Male Age: 45__ DOB: 11-01-66_Number of Victims: 1_________

Type of Victim: (Check Only One)__________________________________________

I-Individual