Fokjny> ,‘LJ>T4,->Tra!fte Misdemeanor □^5 Ortfnance^ , Zb 6 Otrw_ IIWeaponSeUed T • <. v— Enter Type Mumpie-*^' %)*♦ ’Clearance^- s-i • indicator h 4 Locafeon otAnost {Including Named Business) ■z ‘ y 4 . ■? 37ZC ^/r/ ZP- YnrP / / Location of Offense (Busmess^Name.-Address)^ r: ■ Date of arrest ax yO. .<71-