TIBRS Incident Report - SAGE Publications Inc

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TIBRS Incident ReportORI #Incident #CAD #Incident DateIncident TimeIncident Date is:Address #Street NameApt./Suite #StateCityZoneZip CodeLatitudeLongitudeOfficerArrival DateArrival TimeCleared by:ExceptionalClearanceEx. Clearance DateOfficer InvolvedShooting?Cargo Theft?Investigated byOutside AgencyOffense # 1T.C.A. OffenseTIBRS Offense CodeBias Motivation AntiNote: For additional bias entries, use Supplemental Bias Motivation form.Offense StatusOffender Suspected of Using: (check all that apply)N/AIdentity Theft FlagFor BurglaryOffense Only:Home Invasion?AlcoholEntry Method?Weapons: (Required for 09A, 09B, 09C, 09D, 100, 11A, 11B, 11C, 11D, 120, 13A, 13B,64A, 64B, 210 & 520 Offenses)(Check up to three)LocationAutomatic? Check Box if yes.DrugsComputer Equipment# of Premises (Hotel/Motel/Rental Storage)Criminal Activity (check up to three)Required for 250, 280, 35A, 35B 39C, 370, 520,720Firearm-Type plosivesFire/Incendiary DeviceDistributing/SellingIntentional Abuse ping PillsExploiting ChildrenKnife/Cutting gBlunt ObjectOtherMotor ersonal WeaponsNoneShotgunOther FirearmGang Involvement?1st Gang g/Publishing/ProducingType of Gang Involvement?2nd Gang Name?OrganizedAnimal Sexual Abuse

Offense # 1 (continued)Type of Gang Involvement?Gang Involvement?1st Gang Name?2nd Gang Name?1st Gang Type2nd Gang TypeSuspected Drug Type (check one)Drug Related?Methamphetamine LabPrecursor (check one)Origin of Drug (check one)Offense #2T.C.A. OffenseTIBRS Offense CodeBias Motivation Anti-LocationOffense StatusOffender Suspected of Using: (check all that apply)N/AIdentity Theft FlagFor BurglaryOffense Only:Home Invasion?AlcoholEntry Method?DrugsComputer Equipment# of Premises (Hotel/Motel/Rental Storage)Weapons: (Required for 09A, 09B, 09C, 09D, 100, 11A, 11B, 11C, 11D,Criminal Activity (check up to three)120, 13A, 13B, 64A, 64B, 210 & 520 Offenses)Required for 250, 280, 35A, 35B, 39C, 370, 520, 720(Check up to three)Automatic? Check Box if yes.Firearm-Unknown typePoisonHandgunExplosivesRifleFire/Incendiary DeviceShotgunDrugs/Narcotics/Sleeping PillsOther FirearmKnife/Cutting InstrumentAsphyxiationBlunt ObjectOtherMotor VehicleUnknownPersonal WeaponsNoneGang Involvement?1st Gang Name?1st Gang ngIntentional Abuse andTortureUsing/ConsumingExploiting ting/Manufacturing/Publishing/ProducingType of Gang Involvement?2nd Gang Name?2nd Gang TypeOrganizedAnimal Sexual Abuse

Offense #2 (continued)Suspected Drug Type (check one)Drug Related?Methamphetamine LabPrecursor (check one)Origin of Drug (check one)PropertyLoss Information:Item #Loss TypeDescriptionQty.ValueSerial #Recovery informationItem #DescriptionDateQty.Value

Property (continued)Vehicle Information #1License #StateStyleModelColorVIN #License #StateStyleModelColorVIN #YearMakeParts Stolen?DescriptionVehicle Information #2YearMakeParts Stolen?DescriptionDrug InformationDrug 1QuantityMeasureDrug 2QuantityMeasureDrug 3QuantityMeasureFor Marijuana and Measureis Number of PlantsLocation Found# PlotsLongitudeLatitudeOffender/Arrestee #1ArrestedSexFirst NameState Control #DOBRaceEthnicityAddress #CityResident StatusMiddle Name1st AliasAge RangeLast Name2nd AliasApt./Suite #Street NameStateZip CodePhone #

Offender/Arrestee #1 (continued)SSNHeight (FT)Driver License/OLN #(IN)WeightStateHair ColorEye Color1st SMT2nd SMT3rd SMT4th SMTClothing DescriptionTIBRS Arrest OffenseArrest DateArrest Transaction #T.C.A. StatuteArrestee Armed with at Time of Arrest:(Check up to twoType of ArrestT.C.A. Statute OffenseAutomatic? Check Box if yes.HandgunUnarmedRifleKnife/Cutting InstrumentShotgunClub, Blackjack, Brass KnucklesJuvenile DispostionOther FirearmWarrant Signed ByFirearm-TypeUnknownMultiple Clearance DataPrevious Domestic Violence Arrests?Offender/Arrestee #2ArrestedSexFirst NameState Control #DOBRaceEthnicityCitySSNResident StatusMiddle Name1st AliasAddress #Age RangeLast Name2nd AliasApt./Suite #Street NameStateDriver License/OLN #Phone #Zip CodeState

Offender/Arrestee #2Height (FT)(IN)WeightHair ColorEye Color1st SMT2nd SMT3rd SMT4th SMTClothing DescriptionTIBRS Arrest OffenseArrest DateType of ArrestArrest Transaction #T.C.A. StatuteArrestee Armed with at Time of Arrest:(Check up to twoT.C.A. Statute OffenseAutomatic? Check Box if yes.HandgunUnarmedRifleKnife/Cutting InstrumentShotgunClub, Blackjack, Brass KnucklesJuvenile DispostionOther FirearmFirearm-TypeUnknownWarrant Signed ByMultiple Clearance DataPrevious Domestic Violence Arrests?Victim # 1Offense #1Offense #2Offense #3Offense #4Victim TypeSexRaceResident StatusEthnicityAge RangeAge CategoryD.O.B.College StudentOn CampusDomestic ViolenceTransported to SafetyName of CollegeViolation of Order of Protection

Victim # 1 (continued)First NameMiddle NameAddress #Last NameStreet NameApt./SuiteCityStateZipAlt. Phone #SSN #Driver License/OLNStateHeight (FT)INWeightPhone #Hair ColorEye Color1st SMT2nd SMT3rd SMT4th SMTEmployerAddress #Street NameCityStateInjuries (Check up to Five)Homicide/AggravatedAssault Circumstances(Check up to two)NoneBroken BonesPossible Internal InjurySevere LacerationMinor InjuriesOther Major InjuryLoss of TeethUnconsciousnessZipPhone #Justifiable Homicide CodeArgumentAssault on Law OfficialDrug DealingGanglandJuvenile GangAdditional JustifiableHomicide CodesNegligent ManslaughterCircumstancesLover's QuarrelMercy KillingOther Felony InvolvedOther CircumstancesUnknown CircumstancesVictim Relationship to Offender(s)Offender #1Offender #2Offender #3Offender #4Previous DomesticViolence Victim?

Victim #2Offense #1Offense #2Offense #3Offense #4Victim TypeSexResident StatusEthnicityAge CategoryD.O.B.College StudentOn CampusDomestic ViolenceRaceAge RangeName of CollegeTransported to SafetyViolation of Order of ProtectionMiddle NameFirst NameAddress #Last NameStreet NameCityApt./SuiteStateSSN #Alt. Phone #Driver License/OLNHeight (FT)Phone #ZipStateINWeightHair ColorEye Color1st SMT2nd SMT3rd SMT4th SMTEmployerAddress #Street NameCityStateZipPhone #

Victim #2 (continued)Injuries (Check up to Five)Homicide/AggravatedAssault Circumstances(Check up to two)NoneJustifiable Homicide CodeArgumentBroken BonesAssault on Law OfficialPossible Internal InjuryAdditional JustifiableHomicide CodesDrug DealingSevere LacerationGanglandMinor InjuriesJuvenile GangOther Major InjuryNegligent ManslaughterCircumstancesLover's QuarrelLoss of TeethMercy KillingUnconsciousnessOther Felony InvolvedOther CircumstancesUnknown CircumstancesVictim Relationship to Offender(s)Offender #1Offender #2Offender #3Offender #4Previous DomesticViolence Victim?ComplainantFirst NameAddress #CityMiddle NameLast NameStreet NameApt./SuiteStateZipPhone #Alt. Phone #EmployerAddress #Street NameCityStateZipPhone #

Witness #1First NameAddress #Middle NameLast NameStreet NameCityApt./SuiteStatePhone #ZipAlt. Phone #EmployerStreet NameAddress #CityStateZipPhone #Witness #2First NameAddress #CityMiddle NameLast NameStreet NameApt./SuiteStateZipPhone #Alt. Phone #EmployerAddress #Street NameCityStateZipPhone #

Law Enforcement Officer Killed Or Assaulted (LEOKA)Incident #CAD #Vehicle AssignmentNotes: "Other" refers to officers assaulted while in other capacities, such as foot patrol, off duty, etc. "Assisted" refers to lawenforcement assistance only.CircumstancesIf law enforcement official involved is from another jurisdiction, please provide the official's agency and ORI.Agency NameAgency ORIOfficer Involved Shooting InformationIncident #CAD #Officer Sequence #Officer's Weapon TypeIncident Level?Multi-Agency?Officer's Years on Force:LEOKA Incident?Number of Shots Fired by OfficerOfficer's Type of AssignmentDistance Between Officer and SuspectNotes: Data should be either exact distance or a range. Datashould be entered in whole feet using numeric characters.

Narrative

TIBRS Incident Report ORI # Incident # CAD # Incident Date Incident Time Incident Date is: Address # Street Name Apt./Suite # City State Zip Code Zone Latitude Longitude Arrival Date Arrival Time Officer Cleared by: Exceptional Clearance Ex. Clearance Date Offense # 1 T.C.A. Offense TIBRS Offens

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