ATLANTA POLICE DEPARTMENT

Request to Clear/ Cancel a Wanted Notice

ALL of the following information MUST be completed by the agent.

The agent completing this form is:
(check one	)	Officer/Investigator	APD ID Unit Employee

Today’s Date

The following Warrant is to be (check one):	CLEARED	CANCELLED

The reason for removing the warrant from GCIC is: (check all that apply)

Hit Confirmation

Locate (out of jurisdiction)

Teletype (apprehended by Atlanta APD)

Warrant place in error

Name:
Last	First	Middle	Suffix

Date of Birth
Race
Sex

APD #
Warrant #

DATE APPREHENDED OR LOCATED (DOL)

Investigator/ Officer’s NAME (Print):

Investigator/ Officer’s Signature::

Agency/ Dept./ Unit:
APD ID #: (4 digits)

TO BE COMPLETED BY APD ID PERSONNEL ONLY:

Received By:
APD ID #: (4 digits)

Date & Time Received:

Cleared/ Cancelled By:
APD ID #: (4 digits)

Date & Time Removed::

(check)	Attach a copy of the GCIC Clear/ Cancel Confirmation

APD Form 609 revised 5/28/04

Greetings Dr

AJordan

2004-05-28

Atlanta Police Department