Arrest Packet_RedactedI 7s
eoowr,c r,o. oco,nceNcv No LOS ANGEL'ES`CGUNTY SUSPECT PHOTO
5554s22 BOOKING AND PROPERYY RECORD
MAIN No. SID.I CII.No. FBI No. ARN No. DL UC No ;STATE
ARRESTEE'S NAME(LAST.FIRST,MIDDLE) I-IOME PHONE DNA STATUS
M110RA,JOSE
ADDRESS.CfTY,STATE.ZIP OM4 COILECTEDBY:
SEX DESCENT IiAIR EVES HEIGHT WEIGFiT BIRTHD.4TE AGE DATE DNA COLLECTED
M H BRO BRO 503 150 01-07- 1978 41
VEM. LIC. No. ST. RPT DIST AKA/NICKNAME
NA NA 9182 V,e,(
BIRTHPLACE CITI2ENSHIP ARR.AGY.IDETAIL M I ER ADCHG LIVESCANOPERATOR(S)
1941 1'
FILE No. DATE 8 TIME ARRESTED TIME BKO
v0009399 o2-z3-2o 9 oto3 ossa GLrCtC%vVQ.r 1-- Z 7
LOCATION OF ARREST TOTAL841L n-G`' `i'Q V'C. r
14TH ST ALAMO CT 35000.00
n + e,..J ,'` `CHARGE WARRJCAMM.No l
487(D)/PC/ F
JAILLOC. ARRAIGNMENT ATE TIME COURT PR{90PERSS Tl1RE1NFfNB001
LBPS X
SOC.SEC.No. OBSERVABLE PHYSICAL ODDITIES OCCLA ATION
PA1 tiTER
EMPLOYER(FIRMOR PERSONS NAME,CITY S PHONE No.)SPECIAL MEDICAL PROBLEMS
NONE
CLOT}iINGNqRN LOCATION OR DISPOSffION OF VEHICLE
BLK LONG SI,EEVE,B[,U JH:ANS,BLI PD TO V
IN CASE OF EMERGENCV NOTIFV(NAME,RELATIONSHP,ADDRESS,CITY 8 PHONE)
REFI SED
ARRES7ING OFFICER BOOKING EMPLOYEE SEARCHING OFFICER TRANSPORTING OFFICER
MARSCHKE ll002 LIWANAG 7030 VA DEAIOORTN:L 010920 GIBSO\ O10931
CASH RETAINED PROPERTY
00.00
PRISONER'S SIGNATURE FOR RECE IPT OF FOREGOING CASH 8 PROPERTY
CASH DEPQSITED PROPERTY
000000.06 LACES,WALLET,PHONE,PAItiT BRUSH,BELT
LACRISPDLBP-D02 BW PRISONER'S SIGNATURE FOR RECEIPT OF REMAINING CASH8 PROPERTV
20190223 06:34:08
I
J •
DDITIONAL CHARGE NARRANT NUMBER ARR!GN DATE iME COURT
lOBSI(:)/VC/F
66/PC/!t
POSSESS BURGLARY TOOLS
148fA1(1)/PC/ t
OBSTRUCT/E7'C PlB OFCR/H:TC
5200/VC/1
224501:11/VC/1
FAIL STOP VEH:KWALK/ETC
TELEPHONE CALLS OFFICER PRISONER'S INTIIALS
NTERVIEWS-Code:A=A1TY,B=BONDSMAN,D=DOCTOR.E=EMPLOYER,R=RELATIVE,W= WAIVED,0=OTHER HANDLING
NAME CODE PHONEA'OR INTERVIEWER DATE 8 TIME MADE SERIALfA
BAIL DEVIATION O (213) 351-0311
EMARKS
COMPLETED
Misdameanor hold: REP,SON FOR RELEASE _EXPIRATION _fINE CITATION BAIL OTHER
NO DENTIFlCATION RECEIPT i DA7E AND TIME
WARRANT
ON GOING PROBIEM RELEASED BY DOCUMENT ANALYST
NON-CITABLE MISDEMEANOR
OTHER
APPROVED BY RELEASED TO NAME,AGENCY 8 DETAIL)
WATCHCOMMANDER.
RECORD OF PROPERTY TRANSACTIONS CODE. A=ADD W=WITHDRAW I=INSPECT E=REMOVE FOR EVIDENCE
OFFICERNAMEOFPERSON PRISONER'S SIGNATURE AUTHORIZING
ADDING, WITHDRAWING OR INSPECTING NDLING SERIAL yyTHDRAW CODE DESCRIPTION OF PROPERTY DATE AND TIME
OFFICER MAKING FtNAL RELEASE DATE ANO TIME I DO HEREBV ACKNOWLEDGE RECEIPT OF ALL MY REMAINING PROPERTY
IGNATURE
BOOKING IMAGES CA DMV IMAGES
P257 2/23/2019 6:45: 18
IMessage From Termin`al /Un t: STDR Operator: ,( )
Ori inall Sent To: A686 P257 PD01 PR18 -9 Y
Date/Time Sent: 23-FEB-2019 06:45: 18 i
i
CLAM 1LBS0 . ICNDJ .LBSO .
LBSO
CPPROD
LIVE SCAN TRANSACTION AG'ENCY NOTIFICATION
HE FOLLOWING INFORMATION IS IN RESPONSE TO YOUR LIVE SCAN TRANSMISSION
REGARDING SUBJECT/MORA.JOSE , DOB/01071978.
BOOKING AGENCY/CA0194100 , BOOKING NUMBER/5554822, MAIN NUMBER/ , SCN/
i
YOUR SUBJECT HAS BEEN IDENTIFIED BY FINGERPRINTS AS NAM/GARCIA,EDGAR JAVIER
DOB/19780107 CII/
i
DO NOT COLLECT DNA:SAMPLE TYPED/ANALYZED
PALM PRINTS AVAILABLE
III CALIFORNIA ONLY SOURCE RECORD
FBI/
CII/
DOB/19780107 SEX/M RAC/HISPANIC j
HGT/507 WGT/140 EYE/BRO HAI/BLK POB
NAM/Ol GARCIA.EDGAR JAVIER
KA/02 GARCIA,JAVIER
I 4KA/03 GARCIA, ENRIQUE
KA/04 GARCIA, EDGAR ENRIQUE
KA/05 GUTIERREZ,ENRIQUE GARCIA
KA/06 MORA.JOSE
DOB/19780102
CDL/
OC/
INN/CDC-
j
END OF DOJ MESSAGE * * * * * * * * *
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P257 2/23/2019 6:44: 19
Message From Terminal /Unit : STDR Operator: ( )
Originally Sent To: A686 P257 PD01 PR 8' '
Date/Time Sent : 23-FEB-2019 06 :44: 19 j
0/LBPD/T0: LBPD FROM: MBIS 02/23/19 06 :44: 18
Feb 23 , 2019 06:43 : 08
LOS ANGELES COUNTY REGIONAL IDENTIFICAT ION SYSTEM NOTIFICATION
HE FOLLOWING INFORMATION IS RESTRICTED FOR OFFICIAL LAW
ENFORCEMENT USE ONLY
BOOKING AGENCY/CA0194100
IN RESPONSE TO YOUR LIVESCAN IDENTIFICATION REQUEST REGARDING
UBJECT/MORA.JOSE, DOB/01071978, BOOKING NUMBER/5554822
YOUR SUBJECT HAS BEEN IDENTIFIED BY FINIGERPRINTS IN THE LACRIS MBIS
DATABASE AS NAME/MORA.JOSE. DOB/01071978. LA COUNTY MAIN/ ,
SID/ FBI/
I
YOUR IDENTIFICATION REQUEST HAS BEEN FORWARDED TO CAL-DOJ FOR AN
DDITIONAL IDENTIFICATION INQUIRY . RESULTS OF THAT INQUIRY WILL BE
SENT TO YOU DIRECTLY FROM CAL-DOJ .
NTCN :
LTCN :
CN :
OT: CRM I
BKG: 5554822
MAIN :
SID :
FBI :
ENDOF LACRIS MESSAGE * * * * * * * * * * *
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P257 2/23/2019 7 : 00 :48
Message From Terminal /Uni.t : STDR Operator: ( )
Originally Sent To : A686 P257 PD01 PRi8'
Date/Time Sent : 23-FEB-2019 07 : 00 :47 i
CLAM 1LBSO . ICNDJ . LBSO .
LBSO
CPPROD
LIVE SCAN TRANSACTION AGENCY NOTIFICATION
he following infiormation is in response to your Live Scan iris enrollment
ransmission regarding subject MORA,JOSE
ype of Transaction : CRM
Booking Agency: CA0194100
Booking Number: 5554822
SCN #:
Your subject was added to the FBI iris database
ith the FBI-UCN number:
Your transaction has the following note s :
ttention : IRIS ENROLL
ate Submitted : 02/23/2019
CN : !
CR:
i
tatus Messages :
E0001 Mandatory element ' 10 . 13 ' wa's not supplied in message.
Biometric Image Enrollment :
Biometric Set Identifier Image Typ e Pose SMT j
i- ----
11
9 F
END OF DOJ MESSAGE * * * * * * * *
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P?5i = -. 2/23/2019 8:04: 37
essage From Terminal /Unit: STDR Operator: ( )
Originally Sent To: A686 P257 PDOl PR18
Date/Time Sent: 23-FEB-2019 08:04:36
CLAM 1LBS0.ICNDJ .LBSO . i
LBSO
STATE OF CALIFORNIA
DEPARTMENT OF JUSTICE
Bureau of Criminal Identification and Information
P.O. Box 903417
Sacramento, CA 94203-4170
DATE: 02/23/2019
Agency:
CA0194100
RE: FINGERPRINTS SUBMITTED TO THE DEPARTMENT;OF HOMELAND SECURITY
he fiollowing message was generated by the Department of Homeland Security (DHS)
Immigration and Customs Enforcement (ICE) . Ai fingerprint search of the records
contained in the DHS files returned the fiollowing information.
NAME:MORA,JOSE
OCA: 5554822
FBI :
ID:
CRI : CA0194100
DATE SUBMITTED: 02/23/2019
CN #: I i
his record is being sent fior identification purposes only. It does not convey
he individual 's immigration status and is not an immigration detainer.
tatement on Disclosure of Visa Records
i
ccording to the Immigration and Nationality;Act, section 222(f) : The records
of the Department of State and of diplomatic' and consular offices of the United
tates pertaining to the issuance or refusaliof visas or permits to enter the
United States shall be considered confidential and shall be used only for the
formulation, amendment, administration, or enforcement of the immigration.
nationality, and other laws of the United States .
he attached visa record may only be used for the purposes for which it is beingshared. Information in this record may not under any circumstances be disclosed
o any entity other than the receiving agenc,y, including the general public,ithout the express written consent of the Department ofi State (DOS) . Any
questions concerning the interpretation of DOS visa records or the parameters
for disclosure of such records under INA section 222(f) must be add'ressed by the
DOS. However, should access to DOS visa records generate inquiries,' by receiving
agencies about a person's legal status in the United States, such inquiries
should be directed to the Department of Homeland Security (DHS) , which has
jurisdiction over questions of legal status in the United States .
Page 1
P257 2/23/2019 8:'4:37'
MATCH ------
FIN =
EID =
NAME = SERRANO-GONZALES.EDGAR
DOB = 19750701
POB = XX
SEX = M
Photo Attached
LAW ENFORCEMENT SENSITIVE ***
IAQ RECEIVED: 2019/02/ 23 10:01 EST
ORI/ WVFBIID00 ATN/ ORI=CA0349400 CRI=CA0194100 PHN/
BKN/
NAM/ MORA,JOSE
DOB/ Ol/07/1978 CUS/ Y OFF/ 0399 PUR/ C POB/ SEX/ M
FBI/ ARN/ SOC/ SID/
OLN/MNU/ PAS/
REM/ USVFIN=14120920: IDSM=SSCN2019054000025585ENCOUNTER
INFO[EID;LAST;FIRST;MIDDLE;DOB:POB:SEX]25233137;SERRANO-GONZALES;EDGAR; ; 19
750701 :XX:M
QUERY MESSAGE TEXT ENDS - L.E.S.C. RESPONSE BEGINS ****
HIS IS NOT A GOVERNMENT DETAINER! THIS INFORMATION IS FOR
LAW ENFORCEMENT USE AND IS BEING PROVIDED FOR INFORMATIONAL
PURPOSES ONLY.
BASED ON THE INFORMATION PROVIDED *****
HE FOLLOWING I .C. E. RECORD APPEARS TO RELATE:
NAM/ SERRANO-GONZALES, EDGAR
DOB/ 07/Ol/1975
COB/
FCO/ UNK
FBI/
SID/
FFN/ JOSE
MFN/
EVENT NUMBER/
EVENT DATE/ 09/23/2003
COL/ 1
REM/
I .C.E. RECORDS INDICATE THAT THIS SUBJECT IS NOT LEGALLY IN THE
UNITED STATES AND APPEARS TO BE SUBJECT TO REMOVAL PROCEEDINGS.
UBJECT WAS APPREHENDED AND VOLUNTARY RETURNED TO MEXICO
IMPORTANT NOTICE
Page 2
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p257 '= 2/23/2019 8:04:37
r*************** x**********************************
IT APPEARS THAT THIS PERSON HAS A CONVICTIQN •WHZC! COULD BE
CLASSIFIED AS A LEVEL ONE VIOLATOR UNDER THE IMMIGRATION AND CUSTOMS
ENFORCEMENT PROGRAM SECURE COMMUNITIES. AS SUCH: THIS PERSON MAY BEI
MENABLE TO ARREST FOR IMMIGRATION VIOLATIONS
For further information contact ICE Los Angeles . CA;
Aliens IN CUSTODY - Enforcement and Removal Operations at (213) 830-4925
Aliens NOT IN CUSTODY (Roadside) - Homeland Security Investigations at C213) 894- 5501
Or the Law Enforcement Support Center at (802) 872-6020
REQUESTING ORI INFORMATION:
GENCY/
PHONE/ i
L.E.S.C. QUERY ID:
LAST MODIFIED: 2019/02/23 11:03 EST******
LIMITED OFFICIAL USE ***
END OF RESPONSE . . .
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TO/identix@lacrispolbp-i02.lafis.org/ i
Feb 23, 2019 06:27:32
LOS ANGELES COUNTY REGIONAL IDENTIFICATION SYSTEM NOTIFICATION
x * * * * * * * * * * * : *
THE FOLLOWING INFORMATION IS RESTRICTED FOR OFFICIAL LAW
ENFORCEMENT USE ONLY
BOOKING AGENCY/CA0194100 i
IN RESPONSE TO YOUR LIVESCAN IDENTIFICATION REQUEST REGARDING
SUBJECT/MORA,JOSE, DOB/01071978, BOOKING NUMBER/5554822
MAIN NUMBER/ i
YOUR SUBJECT HAS BEEN IDENTIFIED BY FINGERPRINTS 1N THE LACRIS MBIS
DATABASE AS NAME/MORA,JOSE, DOB/01071978, LA COUNTY MAIN/
SID/ FBI/
NTCN:
LTCN:
SCN:
TOT:
BKG: 5554822
MAIN:
SID:
FBI:
i
ENDOFLACRISMESSAGE *; * * * * * * * *
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i;i,;t,,i, i qp,i lni r"'f i i,ip i,,,
file:///C:/Users/idxuser/AnnData/T,cical/TPmn/TriPntix/TPF./7r11995 r._h ld_d(19_hald_S 1 //f119
i
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TO/identix@lacrispolbp-i02.lafis.org/II
Message received on Feb 23, 2019 07:04:13 ij,,;l ,;:
i,. 'i5554822,L50M0540003,L50M0540003,245853 I ''!',
CPPROD I! ' ' i „ I ,,i
LIVE SCAN TRANSACTION AGEN'C.Y'N.OTIFICATIONa ;,;.
i'i, ii;;
I'lii'f ,i":; THE FOLLOWING INFORMATION IS IN RESP a;;, i E TO YOUR LIVE SCAN TRANSMISSIONREGARDINGSUBJECT/MORA,JOSE , DOB/0,;1 ,0,G;978,
BOOKING AGENCY/CA0194100, BOOKING NfU B ER/5554822, MAIN NUMBER/ SCN/ilif!
YOUR SUBJECT HAS BEEN IDENTIFIED BY FI; IIGERPRINTS AS NAM/GARCIA,EDGAR JAVIER
DOB/19780107 CII/ i I1
I Illll` 4 I 1 :,IDONOTCOLLECTDNA:SAMPLE TYPED/ANQ.I ZE'D!
PALM PRINTS AVAILABLE I;II IIi I I:I'' i
III CALIFORNIA ONLY SOURCE RECORD
FBI/
CII/
DOB/19780107 SEX/M RAC/HISPANIC I
HGT/507 WGT/140 EYE/BRO HAI/BLK POB/
NAM/01 GARCIA,EDGAR JAVIER iAKA/02 GARCIA,JAVIER
AKA/03 GARCIA,ENRIQUE
AKA/04 GARCIA,EDGAR ENRIQUE
AKA/05 GUTIERREZ,ENRIQUE GARCIA
AKA/06 MORA,JOSE
DOB/19780102
CDL/
SOC/
INN/CDG
i
I
END OF DOJ MESSAGE * * * * * * * * *
i 'i I, , NTCN: I ;
LTCN: i;f ; !
SCN: I j i i:
TOT: CRM
BKG: 5554822 I,;„ '
MAIN: I j'i ,;°.!;.; :
SID: I ;,Ij I) ti `
I i,',I'1 IFBI: I,:;; i; ,;;I.j' ' I
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i[**:F*** j* i ** IENDOFLACRISMESSA'GE1 ,,y; ; I I ':; ,I, I ii;;
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2019.02. 23-07: 05:22 LACRISPDLBP-102 LACRISPDLB'-D03"BW
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APPROV SGT DID#njEVIDENCEMISSINGINVENTORY PRINTS L.B.P.D. PROPERTY REPORT DR# • SUPP# DATEfTIME OCCURRED CALL#FOUND SAFEKEEPING BLOOD/HAZMAT O.Z .1 ti QUbZ 1' LOST PROPERTY PRISONER'S FREEZER PAGE 1 of LOCATION OF OCCURRENCE CRIME CLASSRECOVEREDPD2240.009(A)(REV.10/04/2013) y ri sT I r G i y ` VICTIM SEX RACE D.O.B.OP LIC# ADDF ESS PHONE#tOWNERSEXRACED.O.B.OP LIC# ADDRESS PHONE#FINDER SEX RACE D.O.B.OP LIC# ADDRESS PHONE#SUSPECT#1 SEX RACE D.O.B.BOOKING# SUSPECT#2 SEX RACE D.O.B.BOOKING#M.ar- 3'oSE M H, a 01 1 555'Y?ITEM# INVOLV DATE ARTICLE(NO GUNS)BRAND(NO GUNS) MODEL SERIAL#OWNER APPLIED# QUANTITY VALUEaa3 ZL o itDw o- T
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1VlG'Tkl, B K SA/ 1LC.o lKE w (3ts -P ' Ya-tv t B ..'R L C—N
REMARKS
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MAKE(GUNS ONLY) TYPE-CAT(GUNS) CALIBER MATERIAL SIZE COLOR DESCRIPTION rsrS,f yT•,
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REMARKS
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IT M# INVOLV DATE ARTICLE(NO GUNS)BRAND(NO GUNS) MODEL SERIAL#OWNERAPPLIED# QUANTITY VALUE
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MAKE(GUNS ONLY TYPE-CAT(GUNS) CALIBER MATERIAL SIZE COLOR DESCRIPTION
C 2t G RY IT M T1''- S C..Q flP v Q W G R-EC-N -I N D l6
REMARKS r
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ITEM# INVOLV DATE ARTICLE(NO GUNS)BRAND(NO GUNS) MODEL ' SERIAL#OWNERAPPLIED# QUANTITY VALUE
MAKE(GUNS ONLY) TYPE-CAT(GUNS) CALIBER MATERIAL SIZE COLOR DESCRIPTION
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NARRATION
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BOOKING No. LOCALAGENCV No LOS ANGELES COUNTY
822 ' BOOKING AND PROPERTY RECORD
MAIN No o FBI No.ARN No. DL LIC No 1 STATE
-
ARRESTEE'S NAME(LAST.FIRST,MIDDLE) I-IOME PHONE DNA STATUS
n oa;,.,os. ON FI l.,E
ITV,STATE,ZIP DW COLLECTEA BY:
SEX DESCENT HAIR EYES HEIGHT WEIGHT BIRTHDATE AGE DATE DNA COLLECTED-
I 11 BRO BRO 503 150 01-07-1978 -tl
VEH.LIC.No. ST RPT DIST AKA/NICKNAME
A 9182
BIRTHPLACE CITI2ENSHIP ARR.AGY.lDETAIL MONIKER ADCHG LIVESCANOPERATOR(S)
19a1
FILE No. DATE 8 TIME ARRESTED TIME BKD
190009399 U2-23-2019 0103 0553
IOCATION OF ARREST TOTAL&41L
1 1TH ST ALAMO CT 3SOU0.00
CHARGE WARRJCOMM No
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JAIL LOC. ARRAIGNMENT DATE TIME COURT PRIS0I ER'SSK'NATUREWhEN BOOI D
1.61'S
SOC.SEC.No. OBSERVABLE PHYSICAL ODDITIES OCCUPATION
i:iti rrrt
EMPLOYER(FIRM OR PERSON'S NAME,CITY&PHONE No.)SPECIAL MEDICAL PROBLEMS
NOiVG
CLOTHING WORN LOCATION OR DISPOSITION OF VEHICLE
13LK LONG Sl.l;l;"1:,13LU JGANS,I3Ll' PD"I'O V
iN CASE OF EMERGENCV NOTIFV(NAME,RELATIONSHIP,ADDRESS,CITY 8 PHONE)
arr si:i
ARRESTING OFFICER BOOKING EMPLOYEE SEARCHING OFFICER TRANSPORTING OFFICER
1,U2SCIII G 11002 LIN'ANAG 7030 VANDE11100RTGL 010920 GII3SON 010931
ASH RETAINED PROPERTY
OU.00
PRISONER'S SIGNATURE FOR RECEIPTOF FOREGOING CASH 8 PROPERTY
CASH DEPOSITED PROPERTY
000000.ob cEs,v:u.rT,iio vt.,P.ai r aos i,a i.T
LACRISPDLBP—D02 BW PRISONER'S SIGNATURE FOR RECEIPT OF REMAINING CASH 8 PROPERTV
F IIIIIIIIIII — 20190223 06:34 :23
IGHT THUMB OUT RIGHT FOUR OUT
UDITiGNAL CHARGF ARRANT NUMBER ARRIGN DATE TIME COURT
10851(al/VC/F
166/PC/M
POSSESS Bl'RGLARY TOO
1-18(A1(1)/PC/M
OI3STRl'CT/ETC Pl'B OFC C I ., li!I' ' I u I
520U/VC/I
22 50(A)/ VC/1
FAIL STOP VF,H:Y i'LK/ETC
TELEPHONE CALLS OFFICER PRISONER'S INTIIALS
NT[RVIE'VS—Cotle.A=ATTY.B=BONDSMHN,D=DOCTOR,E=EMPLOYER,R=REIATNE,W=WAIVED,O=OTHER HANDUNG
dAME CODE PHONEk OR INTERVIEWER DATE 8 TIME MADE SERIAL#
3AIL DEVIATION O (213) 351-0311
2EMARKS COMPLETE
Misdemeanor hold. REASON FOR RELEASE _EXPIRATION __FINE GTATION __BAIL OTHER
NO IDENTIFICAIION RECEIPT# DATE AND TIME
WARRANT
ON GOWG PROBLEM RELEASED BY DOCLIMENT ANAl.YST
NON-CiTABLE A1!SDEMEPNOR
OTHER.
APPROVED BY RE e:,SED TO,r;,ME.:,GENCV 8 DETAiL)
WATCH COMMANDER.
RECORD OF PROPERTY TRANSACTIONS CODE: A=AD W=WITHDRAW I=INSPECT E=REMOVE FOR EVIDENCE
OFRCERNAMEOFPERSON PRISONER'S SIGNATURE AUTHORIZING
ApDING,WITHDRAWING OR INSPECTING HANOLIN#SERIAL yyTHDRAW CODE DESCRIPTION OF PROPERTY DATE AND TIME
OFFlCER MAKING FINAL RELEASE DATE AND TIME I DO IiFREBY FCKNOWLEDGE RECEIPT OF ALL MY REMAINING PROPERTY
IGNATURE i
CA DMV IMAGES
I
LOS ANGELES COUNTY UNIFIED
ARRESTEE MEDICAL SCR ENING FORM
ARRES]'ING AGENCY ARRESTEE NAME; - ' ' BOOI(ING NUIVIBER ' DATE
L-\ \, d ss5 y8 2 2. L- 2't- '
ARRESTEE QUESTIONNAIR E YES : NO REFUSE. c
Do you feel suicidal or feel like hurting yourself? i
1 If yes,complete a Behavioral Observation and Mental Health Referral(Form SH-J-407),Inmate Special Handling Request
Form SH-J-181 or Intranet),and place an"S"(Suicidal)code on the inmate's wristband.
Do any of the following apply to you:(If yes,circle all that apply)
2 Attempted Mental health Underthe care of a mental, Taking psychiatric Hearing things
suicide issues healtli professional , medications that are not there v,
3 Do you require any medical attention? If yes,Why: re?.sfi cl `,PS1—t
4 Do you have any injuries?If yes,what: , - (, 'h +-` v u'j t
Are you currently tal<ing any medications?If yes,complete the below: Td,S1 19,(. / (
Ll1)Name: Dosage: How Often: -
5
2)Name: Dosage: How Often:
3)Name: Dosage: How Often:
Do you have any medical conditions such as:(c'ircle all that apply)j
HIV/AIDS Tuberculosis High Blood Pressure Diabetes
6
Epilepsy Dialysis Open Wound/Abscess/ Boil(MRSA) Other:
If yes to"open wound/abscess/boil,"describe:
Have you been prescribed and/or fitted by a physician to use any of the following:(If yes,circle all that apply
and provide name and contact information of the prescribing phyeician/provider)
Orthopedic or prosthetic Hearin;aid or Tapping cane(blind or visually Wheelr.hair Wall:ing careappiiancecodlearimplantimpairedassisiivedevice)
Facility/provider: Phone number:
Did you have your prescribed medical appliance with you at the time of your arrest?If not,where is the '
prescribed medical appliance now?
Do you regularly use any alcohol or drugs? If so:-- --
1)Name: Last Use:i
How Often: How Mueh:
g 2)Name: S Last Use: I
How Often:How Much:
3)Name: Last Use:;
How Often:How Much:
9
Have you ever been in a"special education"class for slow learners or for emotional problems,considered
developmentally disabled or a client of a regional center?
Are you receiving ongoing medical treatment from any medical fa cility and/or assisted living, board and care,
10 rehabilitation center?If yes,name and contact information of the facility/provider. j
Facility/Provider: Phone N umber:
Females only-Do you have any of the following conditions?(If yes,circie all that apply)
I
11 Birth Control Medication Pregnant—if yes,do you have:Vaginal bleeding and/or Abdominal pain
Lactating/Breastfeeding Other:
ARRESTEE SIGNATURE DATE . .
a5 "c Z 3 • I`l
DEPUTY/OF.FICER WITNESSING EMPLOYEE/ID NUMBER DATE TIME
pv j'z.` S z 23 • )` O b{ -
This form has been reviewed and approved by the Chief Medical Officer and Mental Health Director of Correctional Health Services.
Original signatures are on file with the Correctional Health Services Administration.
SH-R-422(REV 07/Z018)
i
ARRESTING DEPUTY/OFFICER OBSERVATION , .
REQUIRED FOR ALL LASD AND OUTSIDEAGENCY B OICINGS,AT IRC OR SHERIFF STATION JAILS)YES' NO ,
Does the arrestee appear to have any injuries or medical probiems?
1 If yes,describe: \- ,, a- •r c L-. i i-7cz.c'.F'I e-rT`
ARRESTEES WHO HAVE,OR ARE SUSPECTED TO HAVE,AN ACTIVE COMMUNICABLE DISEASEARE TO BE SEGREGA TEDAND TRANSFERRED
TO AN APPROPRIATE MEDICAL FACILITV AS SOON AS POSSIBCE.(TITLE 15,ARTICLE 5,SECTION 1051J
Did the arrestee physically resist arrest and/or require the use of force during the arrest?
2 If so,enter Report#: .. 3
a)If so,did the arrestee receive medical treatment? -.
Did the arrestee threaten suicide or attempt"suicide by cop"during their arrest?
3 Ifyes,initiate a eehavioral Obseivation and Mental Health Referral form(SH-J-407J,Inmate Special Handling Request(SH-J-181 or
IntranetJ,ond ploce an'S"(SuicidalJ code on the inmate's wristband.
Was the arrestee medically treated and cleared?(OK to Book:attach diagnosis/treatment/recommendations paperworkJ
4 Name of clearing medical facility: 5'i. w fl-2 ,r-` e L L ,-- D
Provider:Phone: •S(`L l( `"'`'
5 Does the arrestee appear to be under the influence of alcohol and/or drugs?
fyes,have jailer begin'lntoxication Observation Sheet." y
6 Does the arrestee have any prescribed medications in their property?If yes,list:
Did the arrestee require assistance walking at the time of their arrest?(circle all that apply)
y'Cane Crutches Walker Wheelchair Observed Walking
a)Are you aware ifthe arrestee is currently under the care of a mental health professional,or has a history of inental illness?
If yes,list reason(s),if known.
8 b)Did the arrestee recently exhibit any suicidal,bizarre,or unusual behavioral or is there any other reason to believe the
arrestee suffered from a mental illness at the time of the offense?
Ifyes,initiate a Behavioral Observation and Menta/Health Referral form(SH-1-407J.
9 Is the arrestee suspected of murdering or attempting to murder a family member?
DEPUTY/OFFICER NAME EMPLOYEE/ID,NUMBER - ;DATE; TI.ME.'„`.,::.':' :::.
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JAILER OBSERVATIONS YE5` 'NO'
1 Is the arrestee's consciousness level impaired?Examples:difficult to arouse,difficulty breathing,increased lethargy,unaware
of their location,name,and date. IF YES,SUMMON PARAMEDICS
Z Does the arrestee have obvious symptoms suggesting the need for emergency care?Examples:bleeding,difficulty breathing,
cold clammy perspiration,violent shaking,convulsions. IF YES,SUMMON PARAMEDlCS
3
Does the arrestee appear to have visible signs of.,alcohol/drug withdrawal?(Examples:profuse sweating,profuse vomiting,
anxiety,visual hallucinations. IFYES,SUMMON PARAMEDICS
4 Does the arrestee require more than minimal assistance when walking? If yes,obtain medical evaluation.
5 Does the arrestee require the use of a medical appliance(see Arrestee Questionnaire,question#7)?lf yes,complete ond submit the
Arrestee Medical Appliance Llearonce Record(SH-R-423J form(LASDstaff,refer to CDM 5-03/080.00,5-03/080.10,and5-03/080.15J
Does the arrestee's behavior or statements suggest a risk of suicide?Examples:severe depression,crying,withdrawal,
6 silence,history of previous suicide attempt such as self-inflicted injuries?
Ifyes,p/ace under c/ose supervision/suicide watch,complete a eehaviora!06servation and Mental Hea/th Referralform and transport to
the appropriate Reception Center.
Does the arrestee display any of the following behaviors? Examples:responding to something that is not there,withdrawn, .
bizarre beliefs,rambling nonsensically,overly suspicious,combative without apparent provocation.
Ifyes,complete a Behaviora!Observation and Mental Hea/th Referralform(SH-l-407J and segregate and/or transport to the appropriate
Reception Center.
Does the arrestee appear to be developmentally disabled? If needed,refer to the"Quick Reference Guide for
8 Developmentally Disabled,"provided in Station Jail Manual.
NOTIFY THEAPPROPRIATE REGIONAL CENTER(BYARRESTEE'SZ!P CODE OF RESIDFNCEJ IFARRESTEE IS TO BE HELD MORE THAN 24
HOURS.(TITLE I5,ARTICLE 5,SECTION 1057J
If the orrestee appears to be under the influence of alcohol and/or drugs,the Intoxication Observation Sheet shall be completed.
ANY AFFIRMATIVE ANSWER TO THIS QUESTIONNAIRE SHALL BE BROUGHT TO THE ATTENTION OF THE JAIL SUPERVISOR.**
JAILER SIGNATURE EMPLOYEE/ID NUMBER. : DATE.,,__' ', ',=, : 'iTIME';:'=.''.-: :..;
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JAILSUPERVISORSIGNATURE . EMPLOYEE/IDNUMBER DATE ' TIME;:r',,;.:-`;:::,,::_,:
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DOCTOR'S FINDINGS:
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Transport to,local h'ospital for further treatment. i i f_ .:. c. v; :<; .Transfer to L.A: County Jail. Evaluate at local mental facility. I I .f ; j
D ctor's Si nature i Date TimeReleaseO.R./849(b)(2) PC. Separate from other persons. o g
INTAKE,VITALS:,
NOTES:
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MEDICINE DISTRIBUTION LOG
DatelTime,..,f.,_.A restee Staff ,: Date/Time Arrestee Staff Date/Time Arrestee Staff'
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Release or discontinue date
WHITE - Jail. CANARY' Court Affairs PD-2f00.010(07/13) ,
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DEPARTMENT OF HQMELAIVD SECURITY
IMMIGRATION DETAINER- NOTiCE OF ACTION
SUIJJBCt ID: File No:
Event#: Date: February 23 2oi9
TO:(Name and T'dle af Institution-OR Arry Subsequent Law FROM:(Department of Homeland Security O ce Address}
EnforcementAgency} LOt7C3 BEACH CITY JAIL ERO - Westmin9ter, CA Sub Office
400 P. BROADWAY ICE
LOt7 HEACH, CA 90803 E&O P6RC LAQiJNA NTOVBL
24000 AVILA RD RM# 1552
LAaQNA NIDUBL, CA 92677
Name ofAlien: g@R arro-aorrzaLas, EDGAR AKA: MO&A, SOS$ 8K#: 5554822
Date of Birth: o/oi/19 s Citizenship: I Sex:M
D °,'-F A ,'1{30 JE3 fi Nf0 L .1
z CT FI"JGCY!!p ex1C€ - '-.,a,--_'=_r_.,a 5 'a.-,- 3--^ s M
A final order of removal against the alien;
The pendency of angoing remo al proceedings against the alien;
OX Biometric confirmatlon of the alien's identity and a records check of federal databases that aftirmatively indicate,by themselves
or in addition to other refiable information,that the alien either lacks immigration status or notwithstanding such status is
removable under U.S.irnmigration law;and/or
Statements made by the alien to an immigration offcer and/or other reliable e idence that affirmatively indicate the alien either
lacks immigration status or notwithstanding such status is removable under U.S, immigration law.
o° `;`_-aLi 1'Y0 7R CCJS,Tt Q f'F.C'A RQCE DINNbi 1.;, `T, Yi;( -`" -.. .=::
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Upon completion of the proceeding or investigation for which tfie alien was transferred to your custody, DHS intends to resume
custady of the alien to complete processing andlor make an adrnissibility determination.
IT IS THEREFORE REQUESTED THAT YOU:
Notify DNS as early as practicable(at least 48 hours, if possible},
Ibefore
the alien is released from your custody. Please noti#y
DHS by calling X U.S.Immigration and Customs Enforcement(iCE}or U.S.Customs and Border Protec6on(CBP)at
2is-esa-a92s . If you cannot reach an officiai at the number(s)provided, please contactthe Law Enforcement 5upport
Center at:( 802)872-6d20.
Maiptain custody of the alien for a period NOT TO EXCEED 48 HOUR,S beyond the time when helshe would otherwise have
been refeased from your custody to allow DHS to assume custody.The alien must be served with a copy of this form for the
detainer to take effect. This detainer arises from DHS authorities and should not impact decisions about the alien's bail,
rehabllitation, parole,release,diversion,custody classification,work, quarter assignments, or other matters
Relay thls detainer to any other law enforcement agency to which you transfer custody of the alien.
Notify this office In the event of the alien's death, hospitalization o transfer to another institufion.
If checked:please cancel the detainer related to this alien greiiously submitted to you on date).
J842 CFION6 - DSPORTATION OFFICER
Name and title of Immigration Officer) i ighature of I igration Officer)( 5ign in ink)
Notice:If the alisn may be the victim of a crime or you want the alien to remain in the United States for a law enfiorcement purpose,
notify tha ICE Law Enforcement Support Center at(802)872-6020. You may also call this number if you have any other questions or
concerns about this matter.
TO BE GOMPLETED BY THE LAW ENFORCEMENT AGENCY CURRENTLY FiOLQING THE ALIEN WhlO IS THE SUBJEC7 OF THIS
NOTICE:
Please provide the information below,sign,and return to DHS by rnailing,emailing or faxing a copy to
Loca!Booking/lnmate#: Estimated release date/time:
Date of latest criminal chargelcon iction: Last offense chargedlconviction:
This form was served upon the alien on in the following manner:
in person by inmate mail delivery other(please speclfy};
Name and title of Offlcer) Slgnature of Officer){Sign in ink)
HS Form I-247A(3/17) Page 1 of 3
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U.S.DEPARTMENT OF HOMELAND SECURITY Warrant for ArrestlofAlien
File No.
ate:02%23/2019
Ta: Any immigratian officer autho rized pur uant to sections 236 and 2$7 If the
Immigration and 1'datianaliiy Act and part 287 of title$,Code of Federal
Regulations,to serve warrants of arrest for immigration violations
I have determined that there is probable cause to believe that SERRA.NO-GONZALE5, $nr,.,z
is removable fronn the United States. This determination is based upon;
the execution of a charging docunnent to ir itiate removal proceedings against the subject;
the pendency of ongaing removal roceedings against the subject;
the failure to establish admissibility subse uent to deferred inspection;
p biometric confirrnation of the subject's identity and a records check of federal
databases that affrmatively indicate,by the.mseives or in addition to other reliable
information,that the subject either lacks immigratian status or notwithstandirig such status
is remiovable under U.S. immigration taw; and/or
statements made voluntarily by the subjec to an immigration of.ficer and/or other
reliable evidence that affir natively indicate t ie subject either lacks immigration status or
notwithstanding such status is removaUle under U.S. iintnigration law.
YOU ARE COMMANDED to arrest and talce into custody for removal proceedings under the
Immigration and Nationality Aot,the above-named alien.
C... I --
Signature of A.uthorized I i ion Offccer)
A 3777 GARIBAY - 3action Chief
Prinied Name and Title of Authorized Imiigration Officer)
Certi cate of Service
I hereby certify that the Warrant for Arrest of Alieu was served by me at
Location)
on SEARADId-GONZALES, pc on and the contents ofthis
Name ofAlien) Date of Service)
notice were read to him or her in the language.
Language)
Name and Signature of Officer Name or Number ofInterpreteri(ifapplicab(e)
Form 1-200[Rev.09/16)
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Continuation Pa e for Formi ='
200
U.S.Department of Homeland Security I g
lien's N me File Number Date
SERRANO-GONZALES, EDGAR o2/23/2019
Eveat No:
OTH$ R ALIASRS KNOWN BY
MORA, J03E
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Signatuee Title
A 3777 GARIHA I 3ectiori ChieP
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2 Pagesi
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Form I-831 Continuation Page(Rev.OS/U1/07) i
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Long each Polic Departmenfi
Medic E R car for Rerson in Custody
TO BE COti iPLETED 'Y ACC MPAf YING POLfCEI OFFI R
Name(Last,FirslMiddle Address
v,,,o cz 5 5 c..
Phone Number 5ex Race DOB Nearest Relative and Address Pnone Number
F.1.E M l O 1- 01 - TL'Fn..S Lr
IncidentReportNo:Location Injury/liiness Occured: Trans. O rzrsNnit
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DaEeTme of Jury:Date me Tr nsported hom Jail: Dateffime Retumed to Jai: TotalTme:
Z-2Z. 1 e 51 i
Officers Statemenl Regarding injury and/or Illn ss(DescripUon and Events); Was Injury Related to:i
5 - .Ps+`7 +a t i L. .1 LAr+C k fY Arrest i
c 'r'L C. O N I'I.A- I'L 1. ', .(I 6C Crnne ;
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TO BE COMPLETED BY H SPITAL EMPLOYEE
HOW EIVTER:
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Walked , ( ) Wheelchair Stretcher ( ) Camed In
Paramedics PrivateAmbulance( ) Private Car (. Palice Car
Other Describe
Dat meArrived Attending Physician Nurs
Qt ti z 15
PaFien's Complaints
a ` , r c,- Lu t brc s
Was Patient Able to Answer Was Patient Was Treatment one
Questions Coheren y Dressed? I
eFore Booking
Yes No No
After Booking
TO BE CaMPLETED Bl' PHYSfC1A(r!
Diagnosis: ( , S I
Result df Exam andAuxillaryTest:
i'C.ua•Q. lac.e,,odr, si.t G(
Discharge InstrudionslMedications:
2.(., l.t l,-'i`', I AU(iVi 1,..,
ls Patienfs Condit'ron Lon 8ea h Jail IRC/L/County Jaii USC Medical Center
Sal'isfactory for booking in: Yes ( ) No Yes ( ) No IYes ( ) No
Physician's Name-Print Patient's Signature if Examinalion or Treatment is Refused;
Physici 5ignatur
Boaking ervisor and Pho Jail Supervisorland Pho!o# Date me Comp
23- bGYa
Follow-up 70 E CO E Y JAIL Pi-IYSI l 4R!
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Physician's 5ignature I Dat meo(ExamPnalion I
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DOMESTIC VIOLENCE YES NO
GANG INVOLVEMENT YES o AFtREST REJ4EA ED NOT BOOKED PAGE 1 of
SERGEANT'S DIDtt DATE P OVED TIME PPPF]VED
COMPLEfED BY OFFICER? N ARRANTS Y BOOKING#— r , —
7j v j i
D STATE IN POSS? ARRE TEE'S LAST NAME FIRST MIDDLE
I'1A f`,o L O
ADDRESS APT CITY STATE ZIP CODE
HOME PHONE*SEX RACE HAIR EYES HGT ; WGT D.O.B. AGE VEHICLE LICENSE STATE
c 1 E r 3 '0 3 S l- - 1 +
VEH YR* MAKE* MODEL* SME*COLOR RD AKA BIRTH ST
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DR#ARR AGENCY DATE ARRESTED TIME ARRESTED LOCATION OF ARREST
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PRIMARY CHARGE BAIL WARRANT ADDITIONAL CHARGE BAIL WARRANT#
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ADDITIO AL HARGE BAIL WARRANT# ADDITIONAL CHARGE BAIL WARRANT#
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1 ADDITIONAL CHARGE BAIL WARRANT# `ADDITIONAL CHARGE BAIL WARRANT#
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1, TOTAL BAIL CALL# SOCIAL SECURITY NUMBER OBSERVABLE PHYSICAL ODDffIES/SCARS, MARKS O (SPECIFI
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JGANG INFORMATION* MONIKER* DID#
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ADMITS Y ADMITS Y
AFFILIATIO MEMBE l a
PAROLEE CLETS RECORD TYPE CDC/ID#PAROLE AGENT NAME/OFFICE HOLD YINFOONLYPLACED? N
BUSINESS NAME OGC IPATION TYPE OF BUSINESS* BUSINESS ADDRESS
CITY STATE ZIP CODE BUSINESS PHONE D OBLEMS/INCLUDE PREGNANCY&#OF MO'S
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VEHICLE LOCATION/DISPOSffION
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IN CASE OF EMERGENCY NOTIFY:LAS NAME FIRST
I _ ADDRESS AP STATE ZIP CODE
RELATIONSHIPTOARRESTEE BUSINESS P NE HOME PHONE "
ARRESTING OFFICER'S NAME/DID ASSISTING OFFICER'S NAME/DID*
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SEARCHING OFFICER'S NAME/DID# TRANSPORTING OFFICER'S NAME/DID
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CASH PROPERTY REfAINED BY PRISONER CASH PROPERTY RETAINED BY BOOKING
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CASH PROPERTY DEPOSITED TO RE M/EVIDENCE I .
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FOREIGN WARRANT
82 pC/822PC NOTIFIED YES NO ADVISING OFFICER'S DID WAIVED YES NOARREST ADMONISHMENT
PD4102.013(A)(REV.01/13/99)
OFFICER COPY
J ' . - _ ^ _
LONG BEACH POLICE DEPARTME(dT
DR Sl1PP RELEASED NOT BOOKED INFORMA?ION PAGE of
WAS SUPERVISOR NOTIFIEG YES Np NAME OF SUPERVISOR NOTIFIED
PD4102.013(B)(REV.07I22/9 CONTINUE ON BACK OF AN ADDITIONAL BOOKING FORM
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BOOKING RECORD 5554822 PI134626
y J a i I Housing
FL-6TH—HOLDI
i Booking Date BookingTime
02/23/20 9 05: 53
s_ Booking Name I Race'r 5ex Date of Birth
MORA,JOSE H >M O1/07/1978
Address y
State ZIP Code
Height Weight Hair Color Eye Color POB ST Ethnicity Soc Sec No OLN St Citizen Marital Complex
5'03" 150# BRO BRO MM j
Build Bin/Hanger No I
MAIN131 iOccupationEmployerEmplrPhoneNo
PAINTER NONE
Notify Relative Notify Name
REFUSED
Notify Phone No
Notify Address Notify City
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Notify State NotifyZIP Code
DR No ArrestAgency
19-9399 LONG BEACH PD
Chg Cnts Lvl Charge Warrant No Bail Charge Literal
1 1 F 487 (D)PCGTA I Y 'GRAND ITHEFT AUTO
2 1 F 10851 (A)VC Y VEHICI,E THEFT
3 1 M 466PC Y POSSESS BURGLARY TOOLS
4 1 M 148 (A) (1)PC I Y RESIST/OBSTRUCT PUBLIC OFFICER
5 1 I 5200VC Y DISPLAY OF LICENSE PLATES
6 1 I 22450 (A)VC Y STOP AT LIMIT LINE
BAIL OR FINE
35,000.00
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Page 1 of 1 i 02l2312019 06:02 •
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BOOKING RECORD 555'4822 PI134626
Housing _
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FL-6TH-HOLD
Booking Dale Booking Time
j 02/ 23/2019 05:53
Booking Name Race Sex Date of Birth
MORA,JOSE H M O1/07/1978
Address Cily
State ZIP Code I
Heighl Weight Hair Color Eye Color POB ST Elhnicity Soc Sec No ' OLN St Citizen Marital Complex
5'03" 150# BRO BRO NIl!
Build BinlHanger No
MAIN131
Occupation Employer Emplr Phone No
PAINTER NONE
Notify Relafive Notify Name
REFUSED iNotifyPhoneNa
Notify Address Notify Cily
i
Notify State Notify ZIP Code
DRNo ArrestAgency
19-9399 LONG BEACH PD
I Chg Cnts Lvl Charge Warrant No Bail Charge Literal
1 1 F 487 (D)PCGTA I Y GRAND THEFT AUTO
2 1 F 10851 (A)VC Y VEHICLE THEFT
3 1 M 466PC Y POSSESS BURGLARY TOOLS
4 1 M 148 (A) (1)PC Y RESIST/OBSTRUCT PUBLIC OFFICER
5 1 I 5200VC i Y DISPLAY OF LICENSE PLATES
6 1 2 22450 (A)VC Y STOP AT LIMIT LINE
BAIL OR FINE
35,000. 00
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Page 1 of 1 02/23/20T5'86.12
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Booking Name Mora,Jose I Booking Number 5554822
Arrest Date/Time 02/23/2019 01:03 am Booking Date/Time 02/23/2019 05:53 am
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Arrest Location 14Th SUAlamo Ct Total Bail 35,000.00
Arrest Officer Marschke - 11002
t CHARGES 2
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Charge ChargeLiteral Level i Counts Warrant# Issued Bail BO
10851(A)VC Vehicle Theft Felony i 1 0 Y
148(A)(1)PC Resist/Obstruct Public Oft Mis emeanor 1 0 Y
22450(A)VC Stop At Limit Line Infraction i 1 0 Y
466PC Possess Burglary Tools Misdemeanor 1 0 Y
5200VC Display Of License Plates Infraction ; 1 0 Y
487(D)PCGTA Grand Theft Auto Felony 1 35,000 Y
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Property# Items Bin Hanger# Taking Date Time Searching Release Release Date Time
Y280126 6 MAIN131 02/23/2019 05:58 10920
Item# Description I Date DID Status
1 BLK LONG SLEEVE,BLU JEANS,BLU SHOES 02/23/2019 7030 CW
2 0.00 02/23/2019 7030 CR
3 0.06 02/23/2019 7030 CD
4 LACES,WALLET,PHONE,PAINT BRUSH,BELT 02/23/2019 7030 PD
5 PLYERS,SCREWDRIVER 02/23/2019 7030 SP
6 LTHR JKT,2 SHORT SLEEVE SHIRTS 02/23/2019 7030 SP
ACKNOWLEDGEMENTS
I was rovided with the o
I
p pportunity to make three(3)free completed telephone calls
within the local dialing area in accordance with Penal Code Section 851.5. Initials
I
Property taken from you dur,ing the booking process will be placed into a plastic bag and secured. You will receive it upon your release, or it
will follow you to the transfer facility. If your property is too large to fit'in the bag, it will be placed into the Police Property Storage Warehouse.
You must claim your property within 90 days or it will be disposed of in accordance with the provisions of the Long Beach Municipal Code.
Within 90 days, you may do one of the following:
1. Retrieve the property
2. Authorize in writing, another person to retrieve the property j
3. Notify the Police Department in writing that you are unable to retrieve the property because you are in custody and request that the
Police Department hold the property. If you notify the Police Department that you are unable to retrieve the property within 90 days or
have an authorized person retrieve it for you,the Police Department shall store the property for no longer than 10 months
1D u A-M2T /II S d l/
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Officer Inmate Date
Data Date/Time:02/23/2019/Sat-06:02:53 ps_a0ca2b6c285716d.rpt-edliwan Page 1 of 1
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ARREST
X001 487(D) PC (F) (ALL)
GRAND THEFT:AUTO
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ARREST
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ARREST
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ARREST
X001 5200 VC (I)
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