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FCS-9

ARKANSAS ARREST/ DISPOSITION REPORT Revised 4-02

Case
DEFENDANT IDENTIFICATION Arresting Agency Name Number
Name Last First Middle

Aliases

Street Address Phone No.

Zip
City & State
Central F.B.I. State
System No. No. I.D. No.
Social Drivers License
Security No. No. & State
Sex Race Date of Birth Place of Birth
MO. day yr.
M 1 White 3 Oriental 5 Other
F 2 Negro 4 Amer. Indian 6 Unknown
Hair Eyes Weight Height Scars and Marks

Complexion Build Employer/Occupation

Name of Nearest Relative Phone No.

Street Address City, State, Zip

ARREST
Place of Arrest Arresting Officer(s) Badge Number(s)

Date of Arrest Time of Arrest Bail Amount Set Offense No. Arrestee received from another L. E. Agency

M. 1 Yes 2 No
Classification Date
Felony/Misdemeanor Warrant Number State Crim. Code Charge Description Disposition (Mo., Day, Yr.)

Facts of Arrest (Explain in Detail)

Court Court Right Thumb Print


Hearing Case Phone (Here & On Back)
Date
Complainant Home

Business

Witness Home

Business

Witness Home

Business

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