Police Report

1.
TYPE
OFFENSE/INCIDENT REPORT
INSTRUCTIONS ARE PRINTED SEPARATELY. IF ADDITIONAL SPACE
IS NEEDED, USE REVERSE OF FORM; IDENTIFY ITEMS.
2. CODE NO.
2a. SORT
a. ORIGINAL
b. CONTINUATION
3. TYPE OF OFFENSE OR INCIDENT
c. SUPPLEMENT
OR FOLLOWUP
4. CASE CONTROL NUMBER
murder
4656-613
5. BUILDING NUMBER
6. ADDRESS
7. NAME OF AGENCY/BUREAU
8. AGENCY/BUREAU CODE
5469 east druggie ave.

Atlanta
9. SPECIFIC LOCATION
5555
11a. DATE OF OFFENSE/INCIDENT
11a. TIME OF OFFENSE/INCIDENT
5/30/16
10. LOCATION CODE
Johns home
murder
5556
12.
DAY
13a. DATE REPORTED
13b. TIME REPORTED
6/1/16
9:45
14. DAY
30th
30t
h
15. JURISDICTION (X)
INVOLVED 18. PERSONS
EXCLUSIVE
ID
CODE
(a)
16. NO. OF DEMONSTRATORS

CONCURRENT
PARTIAL
PROPRIETARY
17. NO.
EVACUATED
0
NAME AND ADDRESS

(b)
SE
X
(d)
25
555
TELEPHONE
(g)
HOME
BUSINESS
HOME
Number, Street, Apt. No., City and State
BUSINESS
19. VEHICLE
b.
YEAR
a. STATUS
c. MAKE
STOLEN
GOVT
PERSONAL
VANDALIZ
ED
RECOVERED
e. COLOR (Top/Bottom)
f. IDENTIFYING CHARACTERISTICS
SUSPECT
g.
REGISTRATIO
N
d.
MOD
EL
YEAR
wh
ite
INJURY
CODE
(f)
around
9:00 pm
5469 east druggie street, Atlanta, Georgia

Last Name, First, Middle Initial
RA
CE
(e)
b. TIME END
Number, Street, Apt. No., City and State
TAKEN 20. ITEMS
AGE
(c)
Last Name, First, Middle Initial
Wallus, John, wayne
a. TIME START
around
7:00 pm
STAT
E
TAG
NO.
h. VIN
i. VALUE
a. NAME OF ITEM
b. QUANTITY
e. SERIAL NO.
f. COLOR
g. MODEL
GOVT
h. VALUE
i. UNUSUAL OR UNIQUE FEATURES
j. PROPERTY WAS
k. STATUS OF PROPERTY
SECURRED
UNSECURED
RECOVERED
c. OWNERSHIP
MISSING
PERSONAL
d. BRAND NAME
VALUE RECOVERED
PARTIAL RECOVERY
l. NAME OF ITEM
m. QUANTITY
p. SERIAL NO.
q. COLOR
r. MODEL
GOVT
s. VALUE
t. UNUSUAL OR UNIQUE FEATURES
u. PROPERTY WAS
v. STATUS OF PROPERTY
SECURRED
UNSECURED
RECOVERED
n. OWNERSHIP
MISSING
PERSONAL
PARTIAL RECOVERY
o. BRAND NAME
VALUE RECOVERED
21. NARRATIVE (If additional space is needed, use blank sheet and attach.)
GSA FORM 3155 (REV. 3/200)
GENERAL SERVICES ADMINISTRATION

23a. EVIDENCE
TIME
22. NOTIFICATION
NOTIFIED
YES
ARRIVED
a. Other Police
Agency
b. Fire Department
c. Ambulance
NO
23b. TAG NO.
23c. TYPE
23d. WHERE STORED
24. ATTACHMENTS (Mark X where applicable)
a. CONTINUATION SHEET
b. GSA FORM 3157
c. PROPERTY RECEIPT(S)
e. SUPPLEMENTAL
e. OTHER (Specify)
25. SUSPECT STATUS
26. DISPOSITION OF SUSPECT
a. NOT IDENTIFIED
a. ARRESTED
b. GOVERNMENT EMPLOYEE
c. GOVERNMENT CONTRACT
c. RELEASED
d. NON-GOVERNMENT EMPLOYEE
d. STATEMENT(S)
f. OTHER ATTACHMENTS (Specify)
d. Building Manager
b. NOT ARRESTED
d. N/A
CITATION NUMBER
d. CITATION ISSUED
e. N/A
NOTE: Complete GSA Form 3157 where this is a Suspect, Att. Burglary, Burglary, Att. Robbery, Robbery, or a Weapon is used.
27. TIME
a. RECEIVED
28. REVIEWED BY
b. ARRIVED
a. TYPE
FPS
c. RETURNED TO SERVICE
29a. BADGE
b. SIGNATURE
d. DATE
c. NAME (Printed)
GG
29b. NAME (Printed)
29c. SIGNATURE
29d. DATE
30. CASE REFERRED TO
a. FPS
DETECTIVE
b. LOCAL
POLICE
d. FBI
e. IG
31. CASE
c. STATE POLICE
32. APPROVING OFFICIAL

a. SIGNATURE
a. OPEN
g. OTHER (Specify)
b. CLOSED
c. NAME (Printed)
c. UNFOUNDED
f. N/A
b. DATE
33. DETECTIVE STATUS

a. CASE NUMBER
b. HOW CLOSED
INACTIVE
MEANS
c. SUSPECT
ARREST
OTHER
f. VALUE OF PROPERTY
e. PROPERTY
RECOVERED
d. ENTERED NCIC
DEVELOPED
ARRESTED
g. CLEARED NCIC
YES
h. REFERRED TO
YES
NO
N/A
i. DATE REFERRAL ACCEPTED
21. NARRATIVE (If additional space is needed, use blank sheet and attach.)
NO
N/A
GSA FORM 3155 (REV. 3/200) PAGE 2

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1.

3. TYPE OF OFFENSE OR INCIDENT

4. CASE CONTROL NUMBER

5469 east druggie ave.

11a. DATE OF OFFENSE/INCIDENT

11a. TIME OF OFFENSE/INCIDENT

10. LOCATION CODE

13a. DATE REPORTED

13b. TIME REPORTED

INVOLVED 18. PERSONS

16. NO. OF DEMONSTRATORS

NAME AND ADDRESS

Number, Street, Apt. No., City and State

5469 east druggie street, Atlanta, Georgia

Number, Street, Apt. No., City and State

TAKEN 20. ITEMS

Last Name, First, Middle Initial

Wallus, John, wayne

i. UNUSUAL OR UNIQUE FEATURES

t. UNUSUAL OR UNIQUE FEATURES

GSA FORM 3155 (REV. 3/200)

GENERAL SERVICES ADMINISTRATION

23b. TAG NO.

23d. WHERE STORED

24. ATTACHMENTS (Mark X where applicable)

b. GSA FORM 3157

25. SUSPECT STATUS

26. DISPOSITION OF SUSPECT

f. OTHER ATTACHMENTS (Specify)

29b. NAME (Printed)

30. CASE REFERRED TO

32. APPROVING OFFICIAL

33. DETECTIVE STATUS

i. DATE REFERRAL ACCEPTED

GSA FORM 3155 (REV. 3/200) PAGE 2

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