Drugs I Alcohol? Soaped threatened fMlempted suicide? Is the suspect Parole I Probation? Relation to Victim: Wing together: Can be Identified: Gang/Crew Affiliation: Name: Identifiers: LOCATION ADDRESS CM STAlt/COUNTRY DP APT/ROOM HOW LONG? RES. PCT HOME•PETUAANENT 9 EAST 71 STREET NYC NEW YORK 0 0 Phone

uage: N.Y.C.H.A Resident? NO is Victim tearful Ice their safety I Ede? Escalsling violence / abuse by suspect? Were prior DIR'• prepared for ON? Gang/Crew Affiliation: NO Name: Identifiers: WU View Photo: YES %VI Prosecute: YES Notified Of Crime NO Victim Comp. Law: LOCATION ADDRESS CITY STATE/COUNTRY ZIP

Language: N.Y.C.H.A Resident? Is Victim fearful for Now safety r kle? Escalating violence I abuse by suspect? Were prior DIR's prepared for CN? Gang/Crew Affiliation: Name: Identifiers: Will View Photo: NO VIM Prosecute: YES Notified Of Crime NO VICtIfIl Comp. Law: IMAM A0211119,1321( STATEWIJTRY ZIE AMMO

BUSISNOTS 'derail!CAW ID: Other '00000000000: 864906697 Phyakal Condition: APPARENTLY Uc/Permit NORMAL Type: Drug Used: NONE Lie/Permit No: Gang/Crew Affiliation: NO Name: Identifiers: LOCATION ADDRESS CITY STATEICNTRY ZIP APT/ROOM PCT HOME-PERMANENT 9 EAST 71 STREET MANHATTAN NEW YORK 019 Phone # and