County Sheriff'S Office Incident Report Page 2
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1
2Case Number:
County Sheriff’s Office
123abc
Offense/Incident Report
Date of Report:
09/12/1937
X
X
Report Status:
If this is an OFFENSE:
or
Felony or
Misdemeanor or
OFFENSE
INCIDENT
Petty Offense
(Check one)
(Check one)
Reporting Officer:
Date & TIme of Offense/Incident:
Officer Peter Pupil
09/12/1937, 2:25 p.m.
(Your name goes here)
Name of Person who Reported the Offense/Incident:
Harry Hayseed (W), local farmer
For all people on report, use the following codes:
V = Victim
Ex:
W = Witness
Address and/or Location of Offense/Incident:
Sam Smith (V) reported that...
Smith ranch on Highway 17 in Weed, Calif.
S = Suspect
Reporting Officer’s Summary of Offense/Incident:
Hayseed called police when Shelly Smith (V), age 18, ran to his house,
crying, with scrapes on her hands and knees and wearing a ripped red
dress. Shelly Smith was interviewed at the Hayseed residence. Victim
stated that a worker at her father’s ranch grabbed the back of her
dress. When she told him to let go of her, he continued to tighten
his grip, knocking her to the ground. Smith said she screamed for
help as the man towered over her. Another worker at the ranch, later
identified as George Milton, came upon the attack and grabbed the
larger man, pulling him away from Smith, the victim reported. Both
men were last seen running toward Highway 17. Attacker was identified
as Lennie Small (S). Police dogs were released to track the men, but
neither was located.
I hereby attest that the following report is an accurate representation of witness accounts reported to me and my own personal
observations of the offense/incident scene.
Peter Pupil, Sheriff’ s Deputy
Signature of Reporting Officer
Suspect Information
Name, if known:
Gender:
Age:
Height:
Weight:
Hair:
Eyes:
27
Lennie Small
male
green
320 lb. lt. brw.
6 ft, 10 in.
Was an arrest made?
If no, the suspect’s last known location:
(Check one)
X
Last seen running toward Highway with George Milton
YES
or
NO
On the reverse side of this paper, Reporting Office must draw a sketch of the crime scene/incident layout. Be sure to label any important details.
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