Time: 9:27:55
Case No. . Street Number City « «
Birth Date/Age Occupation Home Phone No. Sex.
Weight
Case Number . Employer Name Address
| Phone Number
REKKEEERE OT H
Street Number City .
Occupation Home Phone No.
Neight .... other Phone Nor:
case Number Address tity/State/Zip
CHEKEKEEK OT
case Number
jtreet Number tity . : 3irth Date/Age :
leight ... ther Phone Nbr:
‘KEEKKERE O TH ‘ase Number
‘ity
iccupation
Other Phone “Nbr:
Case Number . : Birth Date/Age :
SEH ' 2. «© » 8» @ f
itreet Number =:
‘rth Date/Age :
Incident Report
1-05-000368
0/00/0000 oO Employer? FAMILY THERAPIST Oper Lic No. 561/000-0000 Race ‘ Female Height
0 Person Type
561/000-0000
*** EMPLOYER INFORMATION*** 1-05-000368 PBC DIVISON OF YOUTH AFFAIRS 4200 N AUSTRALIAN AV
City/State/Zip : WEST PALM BEACH, FL 33407
561/840-4540
ER PERSO Last Name
Employer?
Oper Lic No.
Race... Height .. 0 Person Type
***EMPLOYER INFORMATION***
: 1-05-000368 “t Name
?hone Number . :
ER . PERSON INFORM a TION = ; RREKKKERKE
1-05-000368 st Name
000 0 Employer?
Jecupation .. : Oper Lic No. iome Phone No. : Race... . eX 2. wk ke Height ...
°
°
PALM BEACH POLICE DEPARTMENT
(Continued)
White 0 OTHER PERSON
INFORM A TT : . = : ; KKEKKKREEE
White 0 OTHER PERSON
[
b6 b7C White 0
0 Person Type OTHER PERSON ER PERSON INFORM a TION B_KKKRKKKKKE 0000 O Employer?
Oper Lic No.
‘ome Phone No. : . Race . ex . . ww Height
HOUSE_OVERSIGHT_018963 |