Atlanta Police Department

Firearm Discharge Report
(Fill in or circle the appropriate information.)
Date:
Time:
Incident #:

Officer’s Name:
Officer’s Unique ID# :

Type of Discharge:
Number of Rounds Discharged:
Accidental
Intentional

Number of Hits:
Number of Misses:	Range:

Target Hit:	Person Wounded:	Person Deceased:	Location of Wound:
None	Yes	No	Yes	No	Yes No
Head
Arm
Person	Yes	No
Chest
Leg
Vehicle	Yes	No	Animal Deceased:	Yes No
Stomach
Back
Structure	Yes	No
Side
Animal	Yes	No	If yes what kind?
Other	Yes	No

Location of Discharge:
Light Conditions
Weather Conditions
Residential
Daylight
Clear-Cold
Rain-Cold
Commercial
Night-Well Lit
Clear-Mild
Rain-Mild
Residential/ Commercial
Night-Moderate Light
Clear-Hot
Parking Lot
Night-Poor Light
Cloudy-Cold
Wooded Area
Inside-Well Light
Cloudy-Mild
Inside a Structure
Inside-Moderate Light
Cloudy-Hot
Other :	Inside-Poor Light
Other :
Other :

Brief narrative of details above:

Completed by:

Print name
Signature
Date

Form APD 720, revised 1/4/02

Atlanta Police Department

VWarnic

2003-12-29

AJordan

APD