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PLEASE

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COMPLAINT

IN THE JUVENILE COURT OF
FULTON COUNTY, GEORGIA

State F.F.#	Case #	File #
Name (last, first, middle)

Age

Date of Birth

AKA

Race

Sex

LIVE With (name)

Residence Phone

Business Phone

Child's Address/Street

(Apt#)

(City)

(County)

(State)

(Zip)

Mother's Name include Mother's Maiden Name In Parenthesis

Residence Phone

Business Phone

Mother's Address/Street

(Apt#)

(City)

(County)

(State)

(Zip)

Father's Name

Residence Phone

Business Phone

Father's Address/Street

(Apt#)

(City)

(County)

(State)

(Zip)

Legal Custodian's Name

Residence Phone

Business Phone

Custodian's Address/Street

(Apt#)

(City)

(County)

(State)

(Zip)

Complaint

Code Section

Misd./Fel.

Date of Offense

Complaint

Code Section

Misd./Fel.

Date of Offense

Complaint

Code Section

Misd./Fel.

Date of Offense

Taken Into Custody

Yes No	By Whom (Name)

Agency

Placement of Deprived Child

Date

Time

Person Notified

By

Via

Date

Time

Detained

Yes No	Authorized By

Place Detained

Date

Time

Released To

Relation

Date

Time

Co-Perpetrators (Names and Ages)

Co-Perpetrators (Names and Ages)

Victim's Name

Residence Phone

Business Phone

Victim's Address/Street

(Apt#)

(City)

(County)

(State)

(Zip)

Victim's Name

Residence Phone

Business Phone

Victim's Address/Street

(Apt#)

(City)

(County)

(State)

(Zip)

Remarks:

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PRINT or TYPE

Case #
File #

Give Complete Details of Offense(s) or Complaint(s) and Apprehension:
Investigating Officer

Agency

P.D. Report #

Phone #

Complainant's Name

Residence Phone

Business Phone

Complainant's Address/Street

(Apt#)

City

(County)

(State)

(Zip)

Complainant's Signature	Date

36-121-194 front and back , revised 6/11/01

JUV-93-2

2 of 2

PRESS HARD

VWarnic

2001-06-11

Atlanta Police Department