Atlanta Police Department

Taser Use Supplemental Report
Incident #	Date

Taser Serial #
Cartridge Serial #
1.	Did the Taser disable the suspect?	Yes	No
2.	Which Taser method was used?	Probes	Drive-Stun	Both
3.	Was the suspect handcuffed and/or leg-shackled prior to being tased?	Yes	No
(If Yes, explain in detail in narrative)
4.	How many darts stuck to the skin or clothing?
5.	Approximate distance to the target at dart launch?
6.	List the officer or medical personnel that removed the darts.
APPLICATION AREAS

(Place “X’s” where probes hit suspect AND “O’s” where stunned)

List the effects of the Taser on the suspect:
Officer
Supervisor
Form APD 669 10/31/07

Firearm Chamber Cylinder Diagram

VLivsey

2008-01-28

JABDET