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9. 10. 11. 12. B. COMMENTS FROM Identifier Defined City 44/CYr AIM iejA State Of Country FL TO Identifier Defined City - 1 eh", Stele or County Nautical Miles Statute Miles 4100 I035 Gallons Roo AIRFRAME Pound, 957 0 9 7 e Flight Tim jgagg_ A. 5 -- Altitude FL Azoo

TO e e l Larry Vlsosid to al AM IMP :_et Number 5. 6. 7. 8. 9. COMMENTS V-1 8 (0 FROM Identifier Defined City Ta'-E^t3oeo State or Cooney i s \,) TO Identifier Defined City WEST N\Lfri fSc-Pci-f State or Country E Nautical Mika 9.0 O Statute Miles /03C Gallons ILIOO AIRFRAME

Provider: Adjudication infommtion 1. 2. 3. 4. Dale Arfaidicaled Crane Location of AdiudicstionrConvidlon Victim Information (County) r (Stele) (County) (State) (County) r (Stele) teatrustS) (State) O Mann O Adult El Para Mull O ana O Ada O tsar O Ma Gender. Gender. Gender. G

judicated Crete Location of AdiudicallonrConviclion Victim Information 1. O minor CI Mat Gender: 2. (Cowen (Sete) O Maw O Mutt Gender: 3. (Cooney) (Stile) K 1Anot O Adult Gender: 4. (Count') (Sale) kin O "Ili K Gender: (County) (Sin) Were you or are you retied to registrabon or co

U LO 50 ?) COTRIP 6. 7. 8. 9. 10. 11. 12. 13. COMMENTS Trip Number 1113 FROM Identifier Defined City vatsr ePo-tA t3c.-Pic,0 Ft_ Stele or Country TO Identifier Defined City Ao MA5 Stale or Country NauticalMiles Statute Miles Gallons Pounds Flight Time z +.4;_; 0( Altitude

x 3 :IAA Trip Number FROM Identifier DeGued City 1eFien ao ro Stair or County TO !deo€F,er Defined City 14../Esr_fitlni ascot 6. State or Cooney . 7. Nautical Miles 8. Statute Miles 9. Oalloas /51DO AIRFRAME 10. Pounds ? 97,1Q. 0 11. Flight Time _ +a(ss_ 12.

ida, this day of 20 - Lad. 'ke i-aft 22 fig L Blot Slabe Morey Pin Puck Dekinebbrfeelanse Homy Yelow. LW-emigre Green vcbm (provided by Stele Allarr•ey) / tukcuiSouNTY COURT JUDGE Form 025 EFTA01625792 IN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT, IN AND FOR PALM BEACH COUN

(Addltamal Can Cents) posuant to Section 938.051 I ). Fkands Statutes lusturordy mandated). • (Additional Coon Costs far load requirements and other Cooney funded programs) pursuant to Section 939.185(1)(a). Florida Statutes (llatuturity maodated where locally authorried) (Tan Court) pursuant to Sectio