PALM BEACH POLICE DEPARTMENT PROPERTY RECEIPT

PBPD Form #52

CONTRIBUTOR'S COPY

<table><thead><tr><th colspan="7">PROPERTY</th></tr><tr><th colspan="3"></th><th colspan="2">FOUND</th><th colspan="2">DECEASED (Probated)</th><th>PERSONAL</th><th colspan="2">CONFISCATED</th><th colspan="2">DESTROY</th></tr><tr><th colspan="3"></th><th colspan="2">EVIENCE</th><th colspan="2">TRIAL</th><th colspan="2">LABORATORY</th><th colspan="2">STOLEN/RECOVERED</th><th colspan="2">OTHER</th></tr></thead><tbody><tr><td colspan="4">INCIDENT/CITATION NUMBER</td><td colspan="2">DATE/TIME RECOVERED</td><td colspan="2">PROPERTY NUMBER (Leave Blank)</td><td colspan="4">BIN NUMBER (Leave Blank)</td></tr><tr><td colspan="12">ADDRESS WHERE PROPERTY IMPOUNDED</td></tr><tr><td colspan="4">DISCOVERED BY / D.O.B.</td><td colspan="4">ADDRESS Street City Zip</td><td colspan="4">PHONE NUMBER</td></tr><tr><td colspan="4">OWNER&#x27;S NAME / D.O.B.</td><td colspan="4">ADDRESS Street City Zip</td><td colspan="4">PHONE NUMBER</td></tr><tr><td colspan="4">SUSPECT&#x27;S NAME / D.O.B.</td><td colspan="4">ADDRESS Street City Zip</td><td colspan="4">PHONE NUMBER</td></tr><tr><td colspan="4">ADDT&#x27;NL SUSPECT / D.O.B.</td><td colspan="4">ADDRESS Street City Zip</td><td colspan="4">PHONE NUMBER</td></tr><tr><td colspan="12">SPECIAL INSTRUCTIONS</td></tr><tr><td>ITEM #</td><td>QUANTITY</td><td>VALUE</td><td colspan="9">DESCRIPTION</td></tr><tr><td>1</td><td></td><td></td><td colspan="9"></td></tr><tr><td>

EFTA00090678