UnkNoYes

Inventory on File?

FelMisd

Agency Name ORI OCADate/Time Arrested

Charge #1

Counts

Vehicle Left at Scene SecuredReleased to other at owners request Name of Other

Unsecure

Impounded Place of storage

On-View Criminal SummonsOrder for Arrest

Consumed Drug/Alcohol

Name (Last, First, Middle)

ResidentNon-Resident

Unknown

Sex

Phone

Phone

Current Address

Employer's Name

VYR Make Model Style Color Plate #/State VIN

RaceD.O.B.

StatusCodes L - Lost S - Stolen R - Recovered D - Damaged Z - Seized B - Burned C - Counterfeit / Forged F - Found

DCI Status Quantity Type Measure Suspected Type

TakenPrintsPhotos

Fingerprint Card Check Digit # (CKN) Arrest Tract Residence Tract Arrest Number

Age Place of BirthCitizenship

Address

Occupation

Scars, Marks, Tattoos

Hgt Wgt HairAlso Known As (Alias Names) Eyes

Social Security # OLN and State Misc. # and Type

Skin Tone

Nearest Relative Name Address Phone

Place of Arrest

DCI Code Offense Jurisdiction (if not arresting agency) Statute # Warr. Date

Counts DCI Code Offense Jurisdiction (if not arresting agency) Statute # Warr. Date

Counts DCI Code Offense Jurisdiction (if not arresting agency) Statute # Warr. Date

Charge #2

Charge #3

1.2.3.

Date/Time

AGENCY

Check up to 3 types of activity for each

Possess Buy Sale Mfg. Importing Operating

A

RR

S

E

E

T

E

INFO

Country of

INFO

If Armed, Type of Weapon

FelMisd

FelMisd

A

RR

SE

T

INFO

V

HE

INFO

C

NO

F

NI

ED

D

UR

SG

AT

A

RR

SE

T

Complainant VictimName: Address Phone:

N

RA

A

I

R

T

EV

Arresting Officer Signature/ID # Date/Time Submitted Supervisor Signature

Case Status:Further Inv.

ClosedInactive

Case Disposition:Cleared By Arrest / No Supplement NeededArrest / No Investigation

Arrestee Signature

Rev. 3/92DCI-608F

S

AT

UT

S

C

MO

P

Citation Warrant

Date/Time Confined Place Confined Committing Magistrate

Type BondWritten PromiseSecured

UnsecuredNo Bond Other

Bond Amount Trial Date Court Of City

Assisting Officer Name/ID # Released By (Name/Department/ID #) Date/Time Released

B

NO

D

ARREST REPORT

Greensboro Police Department

998667

0410200 02/19/2015 13:32

BASS, KELLIS 16 B M

826 N English St, , Greensboro, NC 27405 336-324-9197

DUDLEY HIGH SCHOOL

Student

US

P6

20150213097

1200 LINCOLN ST

' 0

X

X

336-370-8130

Possession Marijuana > 1/2 To 1 1/2Ounces

201 S EDGEWORTH ST, GREENSBORONOT APPLICABLE/NONE

1 1810 90-95(D)(4)X

X

$0.00

0

BYERLY, J. P. (P10996) //

XX