COVERED CI OTHER INCIDENT/CITATION NUMBER bs-5us DATEMME RECOVERED ,c--2frose /0: iitc PROPERTY NUMBER (Leave Fano o5-l02^1 BIN NUMBER (Leave Munk/ / -2- IS 41 7.73RE PRgFITY IPA NDED i ( 2-0 -40 SS Sam City Iv PHONE NUMBER SS Street City ZP PHONE NUMBER SUSPECTS NAME / D.Q.B. 17