### PALM BEACH POLICE DEPARTMENT PROPERTY RECEIPT

CONTRIBUTOR'S COPY

| PBP0 Form *52                                                                                                                                          |                          |                                      |  |                                                      |                     |                               |           |                          |                           |                                   |
|--------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------|--------------------------------------|--|------------------------------------------------------|---------------------|-------------------------------|-----------|--------------------------|---------------------------|-----------------------------------|
| LII FOUND<br>U PROPERTY                                                                                                                                |                          | LI PERSONAL<br>U DECEASED (Probated) |  |                                                      |                     | LI CONFISCATED<br>U DESTROY   |           |                          |                           |                                   |
| Lli EVIDENCE                                                                                                                                           |                          | U TRIAL                              |  | U LABORATORY                                         | CI STOLEN/RECOVERED |                               |           |                          | Lk OTHER                  |                                   |
|                                                                                                                                                        | INCIDENT/CITATION NUMBER |                                      |  | DATE/TIME RECOVERED                                  |                     | PROPERTY NUMBER (Leave Blank) |           | BIN NUMBER (Leave Blank) |                           |                                   |
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| ADDRESS WHERE PROPERTY IMPOUNDED                                                                                                                       |                          |                                      |  |                                                      |                     |                               |           |                          |                           |                                   |
| DISCOVERED BY / D.O.B.                                                                                                                                 |                          |                                      |  | ADDRESS                                              | Street              | City                          | Zip       |                          | PHONE NUMBER              |                                   |
|                                                                                                                                                        |                          |                                      |  |                                                      |                     |                               |           |                          |                           |                                   |
|                                                                                                                                                        | OWNER'S NAME / D.O.B.    |                                      |  | ADDRESS                                              | Street              | CM                            | Zip       |                          | PHONE NUMBER              |                                   |
|                                                                                                                                                        |                          |                                      |  |                                                      |                     |                               |           |                          |                           |                                   |
| SUSPECT'S NAME / D.O.B.                                                                                                                                |                          |                                      |  | ADDRESS                                              | Street              | City                          | Zip       |                          | PHONE NUMBER              |                                   |
|                                                                                                                                                        |                          |                                      |  |                                                      |                     |                               |           |                          |                           |                                   |
| ADDT'NL. SUSPECT / D.O.B.                                                                                                                              |                          |                                      |  | ADDRESS                                              | Street              | City                          | Zip       |                          | PHONE NUMBER              |                                   |
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|                                                                                                                                                        | SPECIAL INSTRUCTIONS     |                                      |  |                                                      |                     |                               |           |                          |                           |                                   |
|                                                                                                                                                        |                          |                                      |  |                                                      |                     |                               |           |                          | FOUND PROPERTY            | CLAIMLI                           |
|                                                                                                                                                        |                          |                                      |  |                                                      |                     |                               |           |                          | 90 DAYS                   | NOT CLAIM 0                       |
| ITEM I                                                                                                                                                 | QUANTITY                 | VALUE                                |  | DESCRIPTION                                          |                     |                               |           |                          |                           |                                   |
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|                                                                                                                                                        |                          |                                      |  | TOTAL PACKAGE WEIGHT                                 |                     |                               |           |                          |                           |                                   |
| I hereby acknowledge that the above list represents all property taken<br>I hereby acknowledge that the above<br>from me and that I have received a co |                          |                                      |  |                                                      |                     |                               |           |                          | list                      | represents all property impounded |
|                                                                                                                                                        |                          |                                      |  | f this receipt.<br>by me in the official performance |                     |                               |           | of my                    | duty as a police officer. |                                   |
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| SIGNATURE                                                                                                                                              |                          |                                      |  | DATE                                                 |                     |                               | SIGNATURE |                          | ID#                       | UNIT                              |
| RECEIVED BY                                                                                                                                            |                          |                                      |  |                                                      |                     |                               |           |                          | DATE/TIME RECEIVED        |                                   |
|                                                                                                                                                        |                          |                                      |  | REASON                                               |                     |                               |           |                          |                           |                                   |
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