Full Text
MOSCOW POLICE DEPARTMENT Statement Form DR # Date: Current Time: Name: Home Work Address: City: State: Zip Code: DOB: Driver License State: Sex: Eye: Hair: Height: Weight: Scars./Tattoos I, , do hereby make the following written statement voluntarily to Officer , of the Moscow Police Department. I certify that this statement, consisting of page(s), is true and correct, to the best of my knowledge: Signature of person filing statement Officers Signature Attachment additional statement if necessary Print Form & Fax to [PHONE REDACTED]