Preview
FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 07/07/2023
Exhibit 6
FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 07/07/2023
Scratch Copy Scanning Only
9
Scratch Copy
Command # 001 Complaint # 2022-001-006421
Print
FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 07/07/2023
FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023
COMPLAINT
NYSCEF DOC. NO. 23REPORT WORKSHEET RECEIVED NYSCEF: 07/07/2023
PD 373-152A (Rev. 07-22} complaint Report ICAD No.
O Juvenile Report
Cmd Pet. Taking Report
Jurisdiction Of Complaint: NYPD (Unless One Of The Following):
O NYPD Transit Bureau O Port Authority Police O U.S. Park Police O Amtrak Police
O NYPD Housing Bureau O Health & Hospitals Corp. Police O N.Y. State Police O Conrail Police
O Triborough Bridge And Tunnel Police O Long Island Railroad M.T.A. O Metro North M.T.A. O Other
O Staten island Rapid Transit Police
Did This Offense Occur on NYC O Yes Cornmand NYC Parks Department Property Name
Parks Department Property? 1 o n (3
Lo lion Of Occurrence
Inside O Rear Of County Zip Code pt#/Room#
O In Front Of O Opposite Of
Cross Streets
Corner
OR
& ON/E ON/W
OS/E DS/W
Military Time Time Da Time Dale
Occurrence Day Of Week Occurrence Time Date Day of Week
An ae O
On Or From Through
Pet Of Occ. Cornplaint # Aided # Accident # Cas Status Unit Referred To Log/Case # File #
Stop Report # Confirmed O Yes Was The Vict rn's Personal s Was The Victim's Personal Inforrnation O Yes
Shots FFred Information Taken Or Possessed? No Used To Commit A Crime? 4Ci-No
Cornp. Recd )irkadio Visible By Patrol Pct. Sector Of Occ. Beat Of Occ. Post OF Occ. Possible Hale Crime Prints Requested
O Walk-In O Phone
O Written O Pick-Up O Yes O Yes lirlfo O Yes dNo
Possibly OYes If Yes, Detective Name Of Gang
O Bullding if Arson: Child Abuse
O Occupied Damage O Explosion
Gang Borough Wheel Log #
O Motor Vehicle O Unoccupied Caused By: O Fire Suspected
Related
O Other Property O Unk OYes I O
Domestic incident Report Required Because Incident involved Persons
Belonging To O Yes Child in Common? Intimate Relationship? Body Worn Camera
Tha NYS Family Court Act Or NYPD Expanded Definition Of A Dornestic Relationship? J No O Yes 140 O Yes ho s O No
ATTEMPTED/ COMPLETED LAW SECTTON SUS. CLASS TYPE COUNTS DESCRIPTION
Top Off. O
c
2nd Off. O O
In 3rd Off. O O
m
4th Off. O O
5th Off. O O
6th Off. O O
7th Off. Q O
8th Oft O O
9Ih Oft O O
10th Off. O O
Residential: House Of Worship: School: Public Transportation:
O Homeless Sheher O Church O PublIc (NYC Dept Of Ed) O Airport Terrninal O Bus Terminal O Taxi/Livery (Unticensed)
O Residence - Private House O Synagogue O Private/Parochial O Bus (NYC Transit) O Ferry/Ferry Terminal O Tramway
O Residence- Apt. Building O Mosque O College/University O Bus (Other) O Taxi (Yellow Licensed) O Transit - NYC Subway
O Residence- Public Housing O Other O Other O Bus Stop O Taxi (LIvery Licensed) O Transit Facility (Other)
Commerclal: O Chain Store O Drug Store O Gym/Fitness Facility O Mobile Food Carts/Stands O Social Club/
o O ATM O C ck Cashing Business O Dry CleanerlLaundry O Hospitai O Photo/Copy Store Policy Location
3 O Bank lothing/Boutique O Factory/Warehouse O Hotel/Motel O Real Estate Office O Storage Facility
O Bar/Night Club O Commercial Building O Fast Food O Jewelry Store O Restaurant/Diner O Store Unclassified
.c O Beauty & Nail Salon D Daycare Facility O Gas Station O Uquor Store O Shoe Store O Supermarket
3 O Book/Card store O Department Store O Grocery/Bodega O Loan Company O Small Merchant O Telecornrn. Store
O Candy Store O Doctor/Dentist - O Variety Store
Indicate Name Of Business 6\ V _ O Video Store
Other: O Cemetery O Marina/Pier O Parking Lot/Garage O Public Building
O Abandoned Building O Construction Site O Open Lot/Area O Private Q Street O Mailbox Inside
O Bridge O Highway/Parkway O Park/Playground O Public O Tunnel O Mallbox Outside O Other
Indicate Name If Known:
Exact Location Within Premises Type. If Known (Choose One):
O Apartmeni O Efevator Equipment Room O Maintenance/Storage Area D Rest Roorn O Motor Vehicle:
O Basement O Freight Elevator O Managernent Offices/ O Roof O Car
O Commercial Establishment O Garage Other Offices O Roof Top Landing O Motorcycle
D Community Center O Hallway O Parking Lot O O Truck
Stairway
O Driveway O Laundry Room O Play/Park Area O Terrace
O Elevator O Lobby/Door/Vestibule O Public Sidewalk O Walkways O Other
INurglary: Forcible Entry? O Yes Ó1'o (FBurglary, Describe: O Vehicle O Truck Location of Entry: O Front Crime Prev. Survey
O Alt- Forcible Entry O Unknown O Bidg. Comrnercial O BIdg. Residential O Trailer O Rear O Side O Roof Requested
(lf Yes, Explain In Details) O Garage O Building Other O Watercraft O Unknown O Other O Yes f£No
Point of Entry: OWindow O Wall Alarrn Bypass Alarm O Y s Alarm Company Name And Telephone ff Complainant/Reporter Present
O Security Gate O Door O Floor OYes o
Company O Yes t•o
O Skylight O Vent/Duct O Other O N/A Responded O N/A During Burglary
Supervisor On Scene O Yes a Was Translator Used: O Yes E "Ro
If Yes, Indicate Name, Address, Phone # and Language
Rank Name (Print) Cmd- Name Phone #
Canvass Conducted O Yes 20 (Indicate Interviews And Results)
Address Language
Taxi Robbery: Partition Present: O Yes..brNo Amber Stress Light Activated O Yes Elffo Method of Conveyance: O Street Hall O Dispatch
Location of PFck-up:
N.Y-C. Dept, Of Ed. School O On School Property School Sponsored Event
Travelling School Safety Division Operations
Incident: O Yes O No O During School Hours O To School O From School O Yes O No Control #
z Victim Status: O General Ed. Student O Special Ed. St ent O Resource Room/Related Servi eacher O School Safely Agent
O Other Staff Other (Speci
m Type of School: O Elementary O I. . chool Nu . School Name:
o O JHS O HS O P. E
Exact Location On School Pro . O Hall O Floor O Classroom # O Cafeteria O Stalicase #
O O Gym/Locker Ro Bathroom # O Playground/Field O On School Grounds O Auditorium O Other
U
Sus talus: OGeneral Ed. Student OSpecial Ed. Student OResource Room/Related Services OTeacher OOther Staff (Title)
Student Intruder Olniruder OVisitor OFamily Member OUnknown OOther
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FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 07/07/2023
Station Of Occurrence Line (# Or Letter) | Transit Po ansit District
N.Y.C.Transit Incident:
O Yes O No
Metro Card: Type. OStudent O ard Metro Card:
Victim's Time And Station Of Entry Into Transit System. IIKnown:
OLost OSenior Citizen Handicapped
OStolen OTranst oyee OPolice Serial # ____
O S/B Train Loc on On rain: O F ont O e O Rear Train Car # )
O N/B Train
I-
O N/B Platforrn O S/6 Pla Boo h # __ D Tumstile Area O Mezzanine O Stairs/RamplEscalator
O Tunn I/Track Ar Passage Way O Toilet FacHity O Street Stairway/St. Escalator O Other
O Elevator
Nagpefi7e'velopment Field Repori Prepared PSA # Field Report #
N.Y.C. Housing
Authority inci .
OYes O No
O No
Is Victim N.Y.C.H.A.
Victim O Individual O Religious Organization O Financial Institution O Society/Public Disabled
Vicum # of Type O Government usiness O On Duty Law Enforcernent Officer O On Duty Firefighter O Yes O No
No
List Name City State Zip Roarn #
IIBusin ss/Organization,
If Person. Last Name . is This Person Not 11Yes, indicate Language
Proficient in English?
O Yes ho
Nickname/Alias/Majden Narne Sex O M le Date Of Birth Age Race:O White O ack
O Arn. Ind./Alaskan Native Asian/Pacific ls.
Female
O Hisp. White O Hisp. Black
ONYS OOther State/Country Zip Apt.# / Room #
Permanent Residence Address (ONYC OHomeless) City
State Zip Apt. # For How
Temporary Residence Address City
Long?
Business Address City State Zip Apt.# / Roorn #
01Provided/Unavailable Business No O Nol Provided/Unavallable
Home Phone No.
D Not Provided/Unavailable E-MailAddress
Gang/Crew Affiliation: If Yes. Indicate Narne Of Gang/Crew Gang/Crew Identi 1ers ( rs, cos. e .
O Yes
5 Victim Level of Injury Injury Type: Medical Treatrnent:
O Dead ACINot Injured O Apparent Broken Bone O Oth ajor injury O Hospilalized O N t Applicable
O Seriously Physically O Unknown O Possible Internal Injury parent Minor Irtjury O Treated and Released from E nknown
Injured O Severe LaceratFon O Unknown O Refused Treatrnent
O Physically Injured O Loss of Teet O Treated at Scene
Victim Was: Actions Of Victim Prior To Incident (Be Specific)
O Shot d O Stabbed
Victim OI Similar lÀcident If Yes, When And Where
(EXCEPT SEX OFFENSE)
O Yes No
is VMtirn Fearful for Their Safety/Life? Escalating Violence/Abuse by Suspect/Arrestee? Were Prior DIRs Prepared for Victim?
O Yes Sho
E
O Yes gÑo O Yes EtNo
O No Will Prosecute fes O No Victim/Relative Notified Of Grirne Victim Comp. Law O Yes o
Wilt View Photo
Is Victim an NYPD MOS Tax Reg. No. Other MOS Agency·
D Yes
Type of Officer Activity/Circurnstances:
O Resp. to Crime in Progress O Afternpting to Arrest O Invest. m. I-1Traffic Stop
o 2 O Burglary in Progress O Civil Disorder (Riot, Viol mbush Q Other
'
O Robbery in Progress O Handli ner O Handling of EDP
1.u....
Officer Assignrnent T
O Two-O e licle O One-Officer Vehicle (Alone) O Detective/Special Assignment (Alone) O Other (Alone)
O One-Officer Vehicle (Assisted) O Detective/Special Assignment (Assisted) O Other (Assisted)
porter O Witness
Reporter/Witness # _ of
First M.1 Is This Person Not if Yes, Indicate Language
Last Name
Proficient in English?
W U 3
Nickname/Allas/Maiden
C
Name
A 4 O /1
Sex O Male Date Of Irth
O Yes
Age
3T4o
Ra · hite O Black
O Am. nd./Alaskan Native O Asian/Pacific is.
dmale O Hisp. White O Hisp. Black
Permanent Residence Address (ONYC ONYS OOther OHomeless) ate/Country Zip Apl.4 / Roorn #
z
t-
State Zip Apl. # For Flow
Temporary Residence Address City
Long?
City Slate Zip Apt.# / Room #
O
Home Phone # ( ) - Business #
Cell Phone # E-Mail Address
Gang/Crew Affiliation: l Yes, Indicate Name Or Gang/Crew Gang/Crew Identifiers (Colors. Beads, Tattoos, Etc ) Position/Relationship To Victim
O Yes o
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FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 07/07/2023
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Victim Name Perpetrator Name Relationship Offense Weapon
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851
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FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 07/07/2023
Vehicle Type: Vehicle Stolen/Attempted 5tolen Frorn:
Vehicle Involvernent:
O Bumed O Car/5UV O E-bikel Scooter O Parking Lot O Street
O Stolen
O Truck O ATV O Public Garage O Driveway
O Atternpled Stolen O Destroyed/Damaged/
O Unauthorized Use Vandalized O Bus O Watercraft O Non-Public Garage O OIher
O Used in a Crime O Other O RV O Trailer
O Motorcycle O Other
No. of Plates License Plate No. State Expiration Type
Plate(s)
O Lost
O Stolen
Vehicle Value
VIN No.
Model Style Edlor Ins. Code Policy No. invoice No.
Year Make
Vehicle Recovered Alarm No. Precinct Transmitted By (Rank, Name) Time Date
Ata namitted
Prior to Alarm Transmittal
O Yes O No O Yes O No
O Vehicle Parts/Accessories Rernoved Veh. Held For Forfeiture
vphic•e O Damaged Non-Motor Vehicle Accident
O Property Removed From Vehicle El Yes O No
O Damaged Vehicts Accident
Property Business O Both
Property Infolvement Key:
C=Lost D=Seized E=Bumed F=Countetteit/Forged G=Found Use: E Personal O LJnknown
A=Stolen 3=Desiroy id/Damaged/Vandalized
Recovered? Value
Property Item No. Quantity Description of Item - Brand. Model Serial No. Value
( Y or N) Recovered
Involvement
C
a
Q.
. .. __ -
IME1 idumber Carrier Phop e Number
Al A
Model Insured? O Yes
Make
4 of6
. . . ..
FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023
UUMPLAINANT'S REPORT OF
NYSCEF DOC. NO.
LOST 23
OR STOLEN PROPERTY/ Complaint No.
RECEIVED NYSCEF: 07/07/2023
IDENTITY THEFT
Precinct
PD 313-1516 (Rev. 08-16) PAGE 1
NOTE: Inforrnation On This Form May Only Be Changed Or Deleted By The Complainant Cornplainant Will Initial Each Change Or
Deletion.
COMPLAINANT/VICTIM INFORMATION
Name (First, Last, M.L) Home Phone No.
gaden , Onow , s
Addres free
Email A Email Address (Allemate) ISP /Screen Name Date of B
O Yes
Reporting This Thef t
The Legal Owner? O No
Has This Crime Been Previously If Yes, Pet./Agency Contacted Complaint/ Case No. Investigator's Name
Reported lo Another NYPD PcL or S
Other Law Enforcement Agency? O No
COMPLAINANT/VICTIM'S LIST OF LOST OR STOLEN PROPERTY
INSTRUCTIONS FOR COMPLAINANT - FALSE REPORT OF LOST OR STOLEN PROPERTY IS A CRIME IN NEW YORK STATE
1. List all items of property lost or stolen. If further space is needed. use additional form(s).
Data"
2. In the "Additional Descriptive section, list any identifying marks, color of article, initials, etc.
3. Complete additionE I sections of this form if items listed include the following: UNLAWFULLY OPENED ACCOUNTS,
CREDIT/DEBIT CARDS, or C ELLULAR PHONE.
ARTICLE ADDITIONAL
(TV Set, Watch etc. If article is QUANTITY MAKE/MANUFACTURER MODEL/SERIAL No. VALUE DESCRIPTIVE
jewelry. indicate warnens or enens) DATA
Stolen CC \
O Lost
O Stolen
O Lost
O Stolen
O Lost
O Stolen
O Lost
O Stolen
O Lost
O Stolen
Describe, in your own words, the circ imstances that led to the loss or tt eft.
ed nrn 6rau£ queawe ondk\eowt
CREDIT/DEBIT CARD INFORMATION (Fill out only when credit/debit cards are reported lost, stolen or used without approval)
Credit/Debit Card Company Banking Institution
When Did Youlast Use Your Credit/Debit Card? Are You Still In Possession O Yes
of the Credit/Debit Card? O No
Are You Wilfing To Provide The Investigator With Your Last Statement Prior To The Theft As Well As Your Final Bill After The Theft? O Yes
(Not Required For Reporting Purposes) O No
CELLULAR PHONE INFORMATION (Fill out only for cetI phone complaints)
Cell Phone No. Cell Phone Company Did You Have a Contract? O Yes
O No
Date Contract Expires Are You Willing To Provide The Investigator With Your Last Statement Prior
To The Theft As Well As Your Final Bill After The Theft? O Yes O No
(Not Required For Reporting Purposes)
TO KNOWINGLY FILE A FALSE REPORT IS A CRIME ) NEW YORK STATE
"A"
FALSE STATEMENTS MADE HEREIN ARE PUNISHABLE AS A CLASS MISDEMEANOR PURSUANT TO SECTION 210.45 OF THE NEW YORK
STATE PENAL LAW. THIS UNISHABLE BY A FINE AND/OR UP A YEAR IN PRISON.
Signature Of Reporter Date
Witnessed By:
(TamNo] '
(Rank/Narne) signature) (Datef
FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023
NYSCEF DOC. NO. 23 PAGE 2 RECEIVED NYSCEF: 07/07/2023
NOTE: INFORMATION ON THIS FORM MAY ONLY BE CHANGED OR DELETED BY THE COMPLAINANT. COMPLAINANT WILL
INITIAL EACH CHANGE OR DELETION
UNLAWFULLY OPENED ACCOUNT INFORMATION
Creditor Account Number
Address (Street, City, State, Zip)
Contact Number Contact Name
Creditor Account Number
Address (Street, City, State, Zip)
Contact Number Contact Name
Creditor Account Number
Address (Street, City, State, Zip)
Contact Number Contact Name
Creditor Account Number
Address (Street, City, State, Zip)
Contact Number Contact Name
OFFENSE CLASSlFICATION/JURISDICTION FOR IDENTITY THEFT/LARCENY
1. Was a credit card/debit card stolen? O Yes O No
2. Was a lost credit card/debit card acquired or used? O Yes O No
3. Do you reside in NYC? O Yes O No
4. Was your personal identification used to obtain O Yes O No
a credit card for which you did not apply?
5. To what address was the card sent?
6. Are you in possession of the physical credit card that O Yes O No
the unauthorized charge(s) were made against?
7. Was your personal identification information O Yes O No
used to purchase property in NYC?
8. Was your personal identification information O Yes O No
used to purchase property outside NYC?
9. Was your personal identification information used in an O Yes O No
attempt to obtain a credit card for which you did not apply?
10. Was a cellular phone account opened unlawfully in O Yes O No
your name?
INFORMATION RELEASE AUTHORIZATION
I, , hereby attest that my name/Social Security Number/other Personal Identifying Information was used to obtain
credit or merchandise without my permission. I authorize the New York City Police Department to contact the above company/creditor(s) to discuss
the account(s) in question. I further authorize the company/creditor(s) to release any and all information on the account relevant to the investigation
and forward any documentation to the investigative unit concerned. I understand that the New York City Police Department will vigorously investigate
this allegation. I further realize that the person committing this crime may be arrested and prosecuted.
Signature Date
FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023
FILL THIS PAGE OUT FOR WANTED JUVENILES / WANTED ADULTS ONLY.
NYSCEF DOC. NO. 23 FOR APPREHENDED/MISSING
RECEIVED NYSCEF: 07/07/2023
JUVENILES FILL OUT JUVENILE REPORTSYSTEM WORKSHEET PD 377-159A.
Total # Number Number Order of OYes If Yes, was Order of Issuing Court
of Ferps./ Docket # Exp. Date of Order of
Wanted Arrested
Suspec
Preview
FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 07/07/2023 Exhibit 6 FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 07/07/2023 Scratch Copy Scanning Only 9 Scratch Copy Command # 001 Complaint # 2022-001-006421 Print FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 07/07/2023 FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023 COMPLAINT NYSCEF DOC. NO. 23REPORT WORKSHEET RECEIVED NYSCEF: 07/07/2023 PD 373-152A (Rev. 07-22} complaint Report ICAD No. O Juvenile Report Cmd Pet. Taking Report Jurisdiction Of Complaint: NYPD (Unless One Of The Following): O NYPD Transit Bureau O Port Authority Police O U.S. Park Police O Amtrak Police O NYPD Housing Bureau O Health & Hospitals Corp. Police O N.Y. State Police O Conrail Police O Triborough Bridge And Tunnel Police O Long Island Railroad M.T.A. O Metro North M.T.A. O Other O Staten island Rapid Transit Police Did This Offense Occur on NYC O Yes Cornmand NYC Parks Department Property Name Parks Department Property? 1 o n (3 Lo lion Of Occurrence Inside O Rear Of County Zip Code pt#/Room# O In Front Of O Opposite Of Cross Streets Corner OR & ON/E ON/W OS/E DS/W Military Time Time Da Time Dale Occurrence Day Of Week Occurrence Time Date Day of Week An ae O On Or From Through Pet Of Occ. Cornplaint # Aided # Accident # Cas Status Unit Referred To Log/Case # File # Stop Report # Confirmed O Yes Was The Vict rn's Personal s Was The Victim's Personal Inforrnation O Yes Shots FFred Information Taken Or Possessed? No Used To Commit A Crime? 4Ci-No Cornp. Recd )irkadio Visible By Patrol Pct. Sector Of Occ. Beat Of Occ. Post OF Occ. Possible Hale Crime Prints Requested O Walk-In O Phone O Written O Pick-Up O Yes O Yes lirlfo O Yes dNo Possibly OYes If Yes, Detective Name Of Gang O Bullding if Arson: Child Abuse O Occupied Damage O Explosion Gang Borough Wheel Log # O Motor Vehicle O Unoccupied Caused By: O Fire Suspected Related O Other Property O Unk OYes I O Domestic incident Report Required Because Incident involved Persons Belonging To O Yes Child in Common? Intimate Relationship? Body Worn Camera Tha NYS Family Court Act Or NYPD Expanded Definition Of A Dornestic Relationship? J No O Yes 140 O Yes ho s O No ATTEMPTED/ COMPLETED LAW SECTTON SUS. CLASS TYPE COUNTS DESCRIPTION Top Off. O c 2nd Off. O O In 3rd Off. O O m 4th Off. O O 5th Off. O O 6th Off. O O 7th Off. Q O 8th Oft O O 9Ih Oft O O 10th Off. O O Residential: House Of Worship: School: Public Transportation: O Homeless Sheher O Church O PublIc (NYC Dept Of Ed) O Airport Terrninal O Bus Terminal O Taxi/Livery (Unticensed) O Residence - Private House O Synagogue O Private/Parochial O Bus (NYC Transit) O Ferry/Ferry Terminal O Tramway O Residence- Apt. Building O Mosque O College/University O Bus (Other) O Taxi (Yellow Licensed) O Transit - NYC Subway O Residence- Public Housing O Other O Other O Bus Stop O Taxi (LIvery Licensed) O Transit Facility (Other) Commerclal: O Chain Store O Drug Store O Gym/Fitness Facility O Mobile Food Carts/Stands O Social Club/ o O ATM O C ck Cashing Business O Dry CleanerlLaundry O Hospitai O Photo/Copy Store Policy Location 3 O Bank lothing/Boutique O Factory/Warehouse O Hotel/Motel O Real Estate Office O Storage Facility O Bar/Night Club O Commercial Building O Fast Food O Jewelry Store O Restaurant/Diner O Store Unclassified .c O Beauty & Nail Salon D Daycare Facility O Gas Station O Uquor Store O Shoe Store O Supermarket 3 O Book/Card store O Department Store O Grocery/Bodega O Loan Company O Small Merchant O Telecornrn. Store O Candy Store O Doctor/Dentist - O Variety Store Indicate Name Of Business 6\ V _ O Video Store Other: O Cemetery O Marina/Pier O Parking Lot/Garage O Public Building O Abandoned Building O Construction Site O Open Lot/Area O Private Q Street O Mailbox Inside O Bridge O Highway/Parkway O Park/Playground O Public O Tunnel O Mallbox Outside O Other Indicate Name If Known: Exact Location Within Premises Type. If Known (Choose One): O Apartmeni O Efevator Equipment Room O Maintenance/Storage Area D Rest Roorn O Motor Vehicle: O Basement O Freight Elevator O Managernent Offices/ O Roof O Car O Commercial Establishment O Garage Other Offices O Roof Top Landing O Motorcycle D Community Center O Hallway O Parking Lot O O Truck Stairway O Driveway O Laundry Room O Play/Park Area O Terrace O Elevator O Lobby/Door/Vestibule O Public Sidewalk O Walkways O Other INurglary: Forcible Entry? O Yes Ó1'o (FBurglary, Describe: O Vehicle O Truck Location of Entry: O Front Crime Prev. Survey O Alt- Forcible Entry O Unknown O Bidg. Comrnercial O BIdg. Residential O Trailer O Rear O Side O Roof Requested (lf Yes, Explain In Details) O Garage O Building Other O Watercraft O Unknown O Other O Yes f£No Point of Entry: OWindow O Wall Alarrn Bypass Alarm O Y s Alarm Company Name And Telephone ff Complainant/Reporter Present O Security Gate O Door O Floor OYes o Company O Yes t•o O Skylight O Vent/Duct O Other O N/A Responded O N/A During Burglary Supervisor On Scene O Yes a Was Translator Used: O Yes E "Ro If Yes, Indicate Name, Address, Phone # and Language Rank Name (Print) Cmd- Name Phone # Canvass Conducted O Yes 20 (Indicate Interviews And Results) Address Language Taxi Robbery: Partition Present: O Yes..brNo Amber Stress Light Activated O Yes Elffo Method of Conveyance: O Street Hall O Dispatch Location of PFck-up: N.Y-C. Dept, Of Ed. School O On School Property School Sponsored Event Travelling School Safety Division Operations Incident: O Yes O No O During School Hours O To School O From School O Yes O No Control # z Victim Status: O General Ed. Student O Special Ed. St ent O Resource Room/Related Servi eacher O School Safely Agent O Other Staff Other (Speci m Type of School: O Elementary O I. . chool Nu . School Name: o O JHS O HS O P. E Exact Location On School Pro . O Hall O Floor O Classroom # O Cafeteria O Stalicase # O O Gym/Locker Ro Bathroom # O Playground/Field O On School Grounds O Auditorium O Other U Sus talus: OGeneral Ed. Student OSpecial Ed. Student OResource Room/Related Services OTeacher OOther Staff (Title) Student Intruder Olniruder OVisitor OFamily Member OUnknown OOther 1 of 6 FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 07/07/2023 Station Of Occurrence Line (# Or Letter) | Transit Po ansit District N.Y.C.Transit Incident: O Yes O No Metro Card: Type. OStudent O ard Metro Card: Victim's Time And Station Of Entry Into Transit System. IIKnown: OLost OSenior Citizen Handicapped OStolen OTranst oyee OPolice Serial # ____ O S/B Train Loc on On rain: O F ont O e O Rear Train Car # ) O N/B Train I- O N/B Platforrn O S/6 Pla Boo h # __ D Tumstile Area O Mezzanine O Stairs/RamplEscalator O Tunn I/Track Ar Passage Way O Toilet FacHity O Street Stairway/St. Escalator O Other O Elevator Nagpefi7e'velopment Field Repori Prepared PSA # Field Report # N.Y.C. Housing Authority inci . OYes O No O No Is Victim N.Y.C.H.A. Victim O Individual O Religious Organization O Financial Institution O Society/Public Disabled Vicum # of Type O Government usiness O On Duty Law Enforcernent Officer O On Duty Firefighter O Yes O No No List Name City State Zip Roarn # IIBusin ss/Organization, If Person. Last Name . is This Person Not 11Yes, indicate Language Proficient in English? O Yes ho Nickname/Alias/Majden Narne Sex O M le Date Of Birth Age Race:O White O ack O Arn. Ind./Alaskan Native Asian/Pacific ls. Female O Hisp. White O Hisp. Black ONYS OOther State/Country Zip Apt.# / Room # Permanent Residence Address (ONYC OHomeless) City State Zip Apt. # For How Temporary Residence Address City Long? Business Address City State Zip Apt.# / Roorn # 01Provided/Unavailable Business No O Nol Provided/Unavallable Home Phone No. D Not Provided/Unavailable E-MailAddress Gang/Crew Affiliation: If Yes. Indicate Narne Of Gang/Crew Gang/Crew Identi 1ers ( rs, cos. e . O Yes 5 Victim Level of Injury Injury Type: Medical Treatrnent: O Dead ACINot Injured O Apparent Broken Bone O Oth ajor injury O Hospilalized O N t Applicable O Seriously Physically O Unknown O Possible Internal Injury parent Minor Irtjury O Treated and Released from E nknown Injured O Severe LaceratFon O Unknown O Refused Treatrnent O Physically Injured O Loss of Teet O Treated at Scene Victim Was: Actions Of Victim Prior To Incident (Be Specific) O Shot d O Stabbed Victim OI Similar lÀcident If Yes, When And Where (EXCEPT SEX OFFENSE) O Yes No is VMtirn Fearful for Their Safety/Life? Escalating Violence/Abuse by Suspect/Arrestee? Were Prior DIRs Prepared for Victim? O Yes Sho E O Yes gÑo O Yes EtNo O No Will Prosecute fes O No Victim/Relative Notified Of Grirne Victim Comp. Law O Yes o Wilt View Photo Is Victim an NYPD MOS Tax Reg. No. Other MOS Agency· D Yes Type of Officer Activity/Circurnstances: O Resp. to Crime in Progress O Afternpting to Arrest O Invest. m. I-1Traffic Stop o 2 O Burglary in Progress O Civil Disorder (Riot, Viol mbush Q Other ' O Robbery in Progress O Handli ner O Handling of EDP 1.u.... Officer Assignrnent T O Two-O e licle O One-Officer Vehicle (Alone) O Detective/Special Assignment (Alone) O Other (Alone) O One-Officer Vehicle (Assisted) O Detective/Special Assignment (Assisted) O Other (Assisted) porter O Witness Reporter/Witness # _ of First M.1 Is This Person Not if Yes, Indicate Language Last Name Proficient in English? W U 3 Nickname/Allas/Maiden C Name A 4 O /1 Sex O Male Date Of Irth O Yes Age 3T4o Ra · hite O Black O Am. nd./Alaskan Native O Asian/Pacific is. dmale O Hisp. White O Hisp. Black Permanent Residence Address (ONYC ONYS OOther OHomeless) ate/Country Zip Apl.4 / Roorn # z t- State Zip Apl. # For Flow Temporary Residence Address City Long? City Slate Zip Apt.# / Room # O Home Phone # ( ) - Business # Cell Phone # E-Mail Address Gang/Crew Affiliation: l Yes, Indicate Name Or Gang/Crew Gang/Crew Identifiers (Colors. Beads, Tattoos, Etc ) Position/Relationship To Victim O Yes o 2of6 FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 07/07/2023 \M +/Pto R/w S½Jes e ed f'f c u h-D O u vdeo (q4c a t e req tru)e date ed Victim Name Perpetrator Name Relationship Offense Weapon 2L/0ld¬ o ls4me Ex 4J a k& (fg. Lr go4.c 851 Sof6 FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 07/07/2023 Vehicle Type: Vehicle Stolen/Attempted 5tolen Frorn: Vehicle Involvernent: O Bumed O Car/5UV O E-bikel Scooter O Parking Lot O Street O Stolen O Truck O ATV O Public Garage O Driveway O Atternpled Stolen O Destroyed/Damaged/ O Unauthorized Use Vandalized O Bus O Watercraft O Non-Public Garage O OIher O Used in a Crime O Other O RV O Trailer O Motorcycle O Other No. of Plates License Plate No. State Expiration Type Plate(s) O Lost O Stolen Vehicle Value VIN No. Model Style Edlor Ins. Code Policy No. invoice No. Year Make Vehicle Recovered Alarm No. Precinct Transmitted By (Rank, Name) Time Date Ata namitted Prior to Alarm Transmittal O Yes O No O Yes O No O Vehicle Parts/Accessories Rernoved Veh. Held For Forfeiture vphic•e O Damaged Non-Motor Vehicle Accident O Property Removed From Vehicle El Yes O No O Damaged Vehicts Accident Property Business O Both Property Infolvement Key: C=Lost D=Seized E=Bumed F=Countetteit/Forged G=Found Use: E Personal O LJnknown A=Stolen 3=Desiroy id/Damaged/Vandalized Recovered? Value Property Item No. Quantity Description of Item - Brand. Model Serial No. Value ( Y or N) Recovered Involvement C a Q. . .. __ - IME1 idumber Carrier Phop e Number Al A Model Insured? O Yes Make 4 of6 . . . .. FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023 UUMPLAINANT'S REPORT OF NYSCEF DOC. NO. LOST 23 OR STOLEN PROPERTY/ Complaint No. RECEIVED NYSCEF: 07/07/2023 IDENTITY THEFT Precinct PD 313-1516 (Rev. 08-16) PAGE 1 NOTE: Inforrnation On This Form May Only Be Changed Or Deleted By The Complainant Cornplainant Will Initial Each Change Or Deletion. COMPLAINANT/VICTIM INFORMATION Name (First, Last, M.L) Home Phone No. gaden , Onow , s Addres free Email A Email Address (Allemate) ISP /Screen Name Date of B O Yes Reporting This Thef t The Legal Owner? O No Has This Crime Been Previously If Yes, Pet./Agency Contacted Complaint/ Case No. Investigator's Name Reported lo Another NYPD PcL or S Other Law Enforcement Agency? O No COMPLAINANT/VICTIM'S LIST OF LOST OR STOLEN PROPERTY INSTRUCTIONS FOR COMPLAINANT - FALSE REPORT OF LOST OR STOLEN PROPERTY IS A CRIME IN NEW YORK STATE 1. List all items of property lost or stolen. If further space is needed. use additional form(s). Data" 2. In the "Additional Descriptive section, list any identifying marks, color of article, initials, etc. 3. Complete additionE I sections of this form if items listed include the following: UNLAWFULLY OPENED ACCOUNTS, CREDIT/DEBIT CARDS, or C ELLULAR PHONE. ARTICLE ADDITIONAL (TV Set, Watch etc. If article is QUANTITY MAKE/MANUFACTURER MODEL/SERIAL No. VALUE DESCRIPTIVE jewelry. indicate warnens or enens) DATA Stolen CC \ O Lost O Stolen O Lost O Stolen O Lost O Stolen O Lost O Stolen O Lost O Stolen Describe, in your own words, the circ imstances that led to the loss or tt eft. ed nrn 6rau£ queawe ondk\eowt CREDIT/DEBIT CARD INFORMATION (Fill out only when credit/debit cards are reported lost, stolen or used without approval) Credit/Debit Card Company Banking Institution When Did Youlast Use Your Credit/Debit Card? Are You Still In Possession O Yes of the Credit/Debit Card? O No Are You Wilfing To Provide The Investigator With Your Last Statement Prior To The Theft As Well As Your Final Bill After The Theft? O Yes (Not Required For Reporting Purposes) O No CELLULAR PHONE INFORMATION (Fill out only for cetI phone complaints) Cell Phone No. Cell Phone Company Did You Have a Contract? O Yes O No Date Contract Expires Are You Willing To Provide The Investigator With Your Last Statement Prior To The Theft As Well As Your Final Bill After The Theft? O Yes O No (Not Required For Reporting Purposes) TO KNOWINGLY FILE A FALSE REPORT IS A CRIME ) NEW YORK STATE "A" FALSE STATEMENTS MADE HEREIN ARE PUNISHABLE AS A CLASS MISDEMEANOR PURSUANT TO SECTION 210.45 OF THE NEW YORK STATE PENAL LAW. THIS UNISHABLE BY A FINE AND/OR UP A YEAR IN PRISON. Signature Of Reporter Date Witnessed By: (TamNo] ' (Rank/Narne) signature) (Datef FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023 NYSCEF DOC. NO. 23 PAGE 2 RECEIVED NYSCEF: 07/07/2023 NOTE: INFORMATION ON THIS FORM MAY ONLY BE CHANGED OR DELETED BY THE COMPLAINANT. COMPLAINANT WILL INITIAL EACH CHANGE OR DELETION UNLAWFULLY OPENED ACCOUNT INFORMATION Creditor Account Number Address (Street, City, State, Zip) Contact Number Contact Name Creditor Account Number Address (Street, City, State, Zip) Contact Number Contact Name Creditor Account Number Address (Street, City, State, Zip) Contact Number Contact Name Creditor Account Number Address (Street, City, State, Zip) Contact Number Contact Name OFFENSE CLASSlFICATION/JURISDICTION FOR IDENTITY THEFT/LARCENY 1. Was a credit card/debit card stolen? O Yes O No 2. Was a lost credit card/debit card acquired or used? O Yes O No 3. Do you reside in NYC? O Yes O No 4. Was your personal identification used to obtain O Yes O No a credit card for which you did not apply? 5. To what address was the card sent? 6. Are you in possession of the physical credit card that O Yes O No the unauthorized charge(s) were made against? 7. Was your personal identification information O Yes O No used to purchase property in NYC? 8. Was your personal identification information O Yes O No used to purchase property outside NYC? 9. Was your personal identification information used in an O Yes O No attempt to obtain a credit card for which you did not apply? 10. Was a cellular phone account opened unlawfully in O Yes O No your name? INFORMATION RELEASE AUTHORIZATION I, , hereby attest that my name/Social Security Number/other Personal Identifying Information was used to obtain credit or merchandise without my permission. I authorize the New York City Police Department to contact the above company/creditor(s) to discuss the account(s) in question. I further authorize the company/creditor(s) to release any and all information on the account relevant to the investigation and forward any documentation to the investigative unit concerned. I understand that the New York City Police Department will vigorously investigate this allegation. I further realize that the person committing this crime may be arrested and prosecuted. Signature Date FILED: NEW YORK COUNTY CLERK 07/07/2023 07:38 PM INDEX NO. 153563/2023 FILL THIS PAGE OUT FOR WANTED JUVENILES / WANTED ADULTS ONLY. NYSCEF DOC. NO. 23 FOR APPREHENDED/MISSING RECEIVED NYSCEF: 07/07/2023 JUVENILES FILL OUT JUVENILE REPORTSYSTEM WORKSHEET PD 377-159A. Total # Number Number Order of OYes If Yes, was Order of Issuing Court of Ferps./ Docket # Exp. Date of Order of Wanted Arrested Suspec