PALM BEACH POLICE DEPARTMENT PROPERTY RECEIPT

PBPD Form #52

CONTRIBUTOR'S COPY

<table><thead><tr><th colspan="3">PROPERTY</th><th colspan="4">FOUND DECEASED (Probated) PERSONAL CONFISCATED DESTROY</th></tr><tr><th colspan="3">EVIDENCE</th><th colspan="4">TRIAL LABORATORY STOLEN/RECOVERED OTHER</th></tr><tr><th colspan="2">INCIDENT/CITATION NUMBER</th><th colspan="2">DATE/TIME RECOVERED</th><th colspan="2">PROPERTY NUMBER (Leave Blank)</th><td>BIN NUMBER (Leave Blank)</th></tr></thead><tbody><tr><td colspan="8">ADDRESS WHERE PROPERTY IMPOUNDED</td></tr><tr><td colspan="4">DISCOVERED BY / D.O.B.</td><td colspan="2">ADDRESS Street City Zip</td><td colspan="2">PHONE NUMBER</td></tr><tr><td colspan="4">OWNER&#x27;S NAME / D.O.B.</td><td colspan="2">ADDRESS Street City Zip</td><td colspan="2">PHONE NUMBER</td></tr><tr><td colspan="4">SUSPECT&#x27;S NAME / D.O.B.</td><td colspan="2">ADDRESS Street City Zip</td><td colspan="2">PHONE NUMBER</td></tr><tr><td colspan="4">ADDTNL SUSPECT / D.O.B.</td><td colspan="2">ADDRESS Street City Zip</td><td colspan="2">PHONE NUMBER</td></tr><tr><td colspan="8">SPECIAL INSTRUCTIONS</td></tr><tr><td colspan="5"></td><td colspan="2"></td><td>FOUND PROPERTY CLAIM 90 DAYS NOT CLAIM</td></tr><tr><td>ITEM #</td><td>QUANTITY</td><td>VALUE</td><td colspan="5">DESCRIPTION</td></tr><tr><td></td><td></td><td></td><td colspan="5">

EFTA00077917