Part 112, page 408

Transcript

The scan is the source; the transcript is machine-generated from it.

IDENTIFICATION REPORT LOCAL NO. ________ 02034 X TE 9 - 14 19 63 TIME 2:12 A.M. P.M. NAME Ball, Robert Allen IDENT. NUMBER ADDRESS 4717 So 17 2nd St || 7 TRUE NAME (Please Print)

RACE-SEX-AGE WATCH LOCATION OF ARREST CENSUS US W/M 38 3 150 Blk WASH 1 - 150 STR. NO. UNIT OCCUPATION b6 Mason b.c. x / b7C

PROPERTY TAKEN FROM PRISONER BOX 34.60 Cash 305

NONE Watch __ __ __ Glasses [] Lighter [] Pen [] Pencil [] Ring : Wallet: Yes [X] No []

SUSPICION OF: [guess: CHARGE] CELL NO 65

DRUNK X WARRANT NO. COURT BAIL $ ACCIDENT: Yes [] No [] O. LIC. C. HOS[illegible] THE ABOVE IS A LIST OF MY PROPERTY. [Signature present]

CHARGER: Yes [] No [] Ref. [] SEARCHED BY SER. NO.

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IDENTIFICATION REPORT NAME (Please Print) ALIAS OR MONICKER Ball, Robert Allen

HEIGHT WEIGHT BUILD COMPLEXION HAIR EYES TEETH 5' 11" 180 [guess: MED] FAIR Brown [guess: Hazel] [guess: Good]

SCARS - MARKS [illegible short notation]

TATTOOS - DEFORMITIES LEFT LOWER LEG LADY TATOO

PECULIARITIES (Speech, Gait, Etc.) TYPE OF NOSE TYPE OF CHIN [guess: Roman] [guess: Round] DESCENT

CITIZEN BIRTHDAY BIRTHPLACE (Please Print) 9 - 22 - 24 NEB

OCCUPATION EMPLOYED TIME IN CITY TIME IN STATE TIME IN U.S. Yes [] No []

EDUCATION MA K.C.W. PRE b6 Yes [] No [] Yes b7C REMARKS: IDENTIFICATION SIGNATURE - 21 [Signature present] 1831 DATE TIME PLAIN IMPRESSION - RIGHT HAND 9/14/63 4:00 P.M. PROCESSED BY SER. NO. CHECKED BY SER. N [Signature] E 534 ___

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DISPOSITION DATE 9 - 16 CODE 3 FORFEITED NOT GUILTY DISMISSED STRICKEN $ 20 FINED FINE SUSPENDED DAYS COMMITTED DAYS SUSPEN[ded] $________ $________ SENT. DEFERRED PROBATION OTHER

REMARKS

DB COOPER-51264