Full Text
KALISPELL POLICE DEPARTMENT Runaway Juvenile/Missing Person Report Date Time Incident No. Complainant’s Name Complainant’s Address Telephone Number Name of Runaway/Missing Person Aliases Date of Birth Social Security Number Driver’s License Number DL State Date & Time of Last Contact Location of Last Contact On Probation or Parole Name of Supervising Officer Possible Destination Possible Companions Yes No Place of Birth Sex Race Height Eye Color Male Asian or Pacific Islander Black Gray Female Black Blue Green American Indian/Alaskan Native Weight Brown Hazel White Unknown Unknown Hair Color Skin Tone Scars, marks, tattoos, piercings and other characteristics Black Brown Black Light Olive Blonde Sandy Dark Lt. Brown Ruddy Gray White Dk Brown Medium Sallow Red/Auburn Unknown Fair Med Brown Yellow Miscellaneous – Include clothing description, hair description, build, handedness, any illness or diseases, etc. Jewelry Description License Plate Number State Year Expires License Plate Type Vehicle Identification Number Vehicle Year Vehicle Make Vehicle Model Vehicle Style Vehicle Color Additional Vehicle Identifiers Does missing person have corrected vision? Has missing person ever donated blood? Has missing person ever been fingerprinted? No Glasses Contacts No Yes Where? No Yes If so, by whom? Corrective Vision Prescription Blood Type Circumcision Footprints Available Body X-Rays Was Yes Full Was Not No Partial Unknown None STATEMENT OF REPORTING PERSON: I, the undersigned, hereby declare this to be a true and correct report. I am the legal guardian or person who has the legal custody of this runaway juvenile. I understand that I may be charged with violation of MCA 45-7-205 “False Reports to Law Enforcement Authorities” by filing a false report. I also understand that this juvenile report will be submitted to the Juvenile Authorities for information and/or action on the runaway. I will provide transportation for the runaway when apprehended. Complainant’s signature Date Police Department Representative To be completed by ATL B/C: Date Time By Cancelled: Date Time By Dispatch Teletype (attach copy) sent to: Date Time By Cancelled: Date Time By NCIC Entry: Date By NIC# Cancelled: Date By Located: Date Where Agency