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LOS ANGELES COUNTY SHERIFI

NOTICE TO APPEAR ~ ~~~~i~~FFIC AA 074255 I FIELD ARREST - 1.0. - BOOKING REPORT - PROBABLE CAUSE DECLARATION A
STATION
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I 0 MISDEMEANOR
0 CONTINUATION FORM USED
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COUNTY OF LOS ANGELES
SHERIFF'S DEPARTMENT 0 POLICE DEPARTMENT
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JJATE I TIME I DAY OF WEEK IR.D. ,'DRIVERS LlC' ISTATE I BOOKING. 1 INCIDENT< i::J
01/01/00 16.'54 ~ 5400
NAME (FIRST, MIDDLE, LAST)
WCHAEL T KOLLAT
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ARRESTEES
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NAME (LAST, FIRST, MI)
2 •
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0 MALE 0 ADULT
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ADDRESS' , • I 4
CHARGES/DESCRIPTION
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I 5 0 FEMALE 6 0 JUVENILE
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CITY
151
BIDlliNI
N WASHINGTON
STATE
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ZIP CODE
00000
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0 MISD.
0 FELONY
BAILAMOUNT

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DRIVER'S LICENSE STA:E CLASS I BIRTHDATE I[ 1JUVENILE _ ffi 0

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M.l0b581 WI 031377 TEL NO. [ 1 U B - - 0 FELONY_ - ~

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VEH. LlC. NO. [ 1 VIN I

STATE 'If>,SSENGERST0 CV 15210(b) V.C. ~. c 0 FELONY ~'1
1M F 1 0 H.M. 353 vc. Z
REGISTEREDOWNER OR LESSEE [ 1 SAME AS DRIVER I i= 8 LOCATION CRIME(S) OCCURRED I 9 A.D.

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ADDRESS OF OWNER OR LESSEE [ 1 SAME AS DRIVER I ~
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FINANCIAL RESPONSIBILITY INFORMATION
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T[ 1 BOOKING REQUIRED
BOOKING NUMBER
.1 ~ LOCATION OF ARREST IR D
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ELIGIBLE FOR DISMISSAL PER 40610(b) V.C. 1 6308132
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f-iD~AT.TE~&;-CT~IM~E~O~F'CA;';'R;;;R~ES~T'------'Ir--EV-'D-E-N-C-E-----"'f7; IW"'f-!~ER"'E"'E"'V;;:'D"'EN"'c"'E,--I

YES NO . VIOLATION(S) DESCRIPTION(S) 11 12 HELD 0 YES 0 NO ~~ D

o IJ 647(F)PC DISORD CONDUCT:uI/DRUG.ALCOHOL ! COURT/DIVISION ARRAIGNMENT DATE TIME

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I 14
ARRESTING OFFICER. SERIAL No., AGENCY. ASSIGNMENT
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_D~~ AS: ~Cf:!AEL 7 NT", ~.. KOlLAT , I- ::ANSPORTATION OFFICER. SERIAL No., AGENCY. ASSIGNMENT I BUSNEH~LE NO.;

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I FILE NO.
027360 [ ~l V.C. CHILD RESTRAINT 027315 [ • 1 VC. SEAT BELT I AKAI~AM"A~AbUV"',"v

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MC," CU 10

ATTACH
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HOME ADDRESS PHONE No. PHOTO"

APPROX. SPD. I PF. SPD. I VEH. SPD. LMT I RtDAt ICITY ffi !:x -'IDES~: IHAIR I EYES IHT IWT 1 DOB _ I IAGE

LOCATI~N OF VIOLATlON(S)
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u:: OBSERVABLE
21
PHYSICAL
22
ODDITIES
23 24 ' 25 -,
I 126
DATE & TIME BOOKED
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IRC
HiNi. IOLATION NOT COMMITTED IN MY PRESENCE.CERTIFIEOON INFORMATION AND BELIEF
I 'IiDECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF-IHE STATE
OF CALIFORNIA THAT THE FOREGOINGIS TRUE AND CORRECT.
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CLOTHING

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WORN

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DATE ISSUING o~~ EMP..NO. VACATION. S2 AIDS 0 YES V.D. 0 YES HEPATITIS 0 YES HAVE 0 YES ~~~~ 0 YES MEDICAL PROBLEMS 2':
••.•. r::/r']Q) >nv,:' '~~ 30 0 NO 0 0 0 NO .0
'01/01/00 ;?D 43,:::)",I/c../ -ezr= g PERSONAL PROPERTY RETAINED
NO NO TB. TB.

ICASHRETAINED
NO

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ARRESTING OFFICER, IF DIFFERENT FROM ABOVE EMPL NO. m 31 .- -.- -,;._- -- \ • -

....---" A ~ ./ PERSONAL PROPERTY DEPOSITED CASH DEPOSITED

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1/;:.1 \ WITHOUT ADMIWN<l,.lil<l11J';,1PROMISE;.!f} APPE~I-+W"'>lMEcMl't.IllACE
I~-XSIG1')ATURE' -.'-~,,;---' --~~ .... 7"" _ .,,,".;'"j ,_~~ - - -
1:iS'f1'lJ'BElOW I
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32
BOOKING OFFICER, SERIAL No., AGENCY, ASSIGNMENT
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" COURT PA$A!)ENA1HJNfCJPAL"tOURT l 34 0 DETAINED 35 DETENTION LOCATION -

w o RE[EASED - ..
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ADDRESS 200 N. GARFIELDAVENUE. _ > PARENTS (NAME. ADDRESS. PHONE NO.) 1PARENTS NOTIFIED

i= 36 ITIME
CITY PASADENA.
____________
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ADVISED
37
RIGHTS BY I DETECTIVE (SERIAL No., UNIT. DETAIL. PHONE NO.)
,
BY

- AM Iii r;A~D;nD""T'liIO"N
••A'L ""'N:O;FO"'R;;:MihAT.TIr;O"N-------------~------I
ON THE ~AY OF JAllfllA.I?V 19 !llir JlA"Q PM C 38

OR YOU MAY ATTEND NIGHT COURT ON AT 0 PM NO NIGHT COURT AVAILABLE I OTHER REPORTS
39 0 YES 0 NO
I REPORTING
40
OFFICER (SERIAL No., AGENCY. PHONE NO.)

'~APPROVED BY THE JUDICIAL COUNCIL OF CALIFORNIA '*I: CII No. IMAIN No IS S N

'-01-91 S0400 40513(b) 40522 V.C. 853.9 P.C· C '. . o.
~CR~ (REV 08-01-01)-9-95 , ~:;;;~4;-;1~:_;_;:-:-::~_:=:-------1-------------L--------.J
/"'f406.SH-CR-558-A REV. 4/93

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~'\ '" PROPERTY COpy

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