0 proVicied 0 positive- oral Mild sample to preicsibed drug . . LI refusecitfailed4o comply with request for oral fluid! blood sample! alcotest 1 Breath Analysis 0 were under the Influence of I ng liquor or drug DIRECTION -Cittl not wit I skc MUST Tic K Ai B & E • — SAME ofFiceR - . ' • - Asa result

cohol O provided a Positive oral fhild sample to a pritcribed drug 0 refusedtfalledto comply with request for oral fluid! blood sample f alcotest / Breath Analysis O wore under the influence of intoxicating liquor or drug (DUI) . DIRECTION -CAN MK &NNW • -. SFIME C)PriceR 7 /46 frt ( e . n citti t S ...

ohol O prevideaa positive oral fluid sample to a prascrIbed drug O refusecllfalled to comply with request for oral fluid I blood sample! alcotest / Breath Analysis O were under the Influence of intoxicating liquor or drug (DUI) DIRECTION - CAN 11CK Mit• • • -• .., L AME OFFICER . - irccerr t4Pa t M I 0.)