PALM BEACH POLICE DEPARTMENT
PROPERTY RECEIPT
CONTRIBUTOR'S COPY
PBPO Form *52
U PROPERTY [a FOUND 0 DECEASED (Probated) Clil PERSONAL 0 CONFISCATED U DESTROY
U EVIDENCE U TRIAL LI LABORATORY U STOLEN/RECOVERED 01OTHER
INCIDENT/CITATION NUMBER DATE/TIME RECOVERED PROPERTY NUMBER (Leave Blank) BIN NUMBER (Leave Blank)
ADDRESS WHERE PROPERTY IMPOUNDED
DISCOVERED BY / D.O.B. ADDRESS Street City Zip PHONE NUMBER
OWNER'S NAME / D.O.B. ADDRESS Street City Zip PHONE NUMBER
SUSPECTS NAME / D.O.B. ADDRESS Street City Zip PHONE NUMBER
ADDT'NL SUSPECT / D.O.B. ADDRESS Street City Zip PHONE NUMBER
SPECIAL INSTRUCTIONS
FOUND PROPERTY CLAIM C..1
90 DAYS NOT CLAIM U
ITEM # QUANTITY VALUE DESCRIPTION
TOTAL PACKAGE WEIGHT
I hereby acknowledge that the above list represents all property taken I hereby acknowledge that the above list represents all property impounded
from me and that I have received a copy of this receipt. by me in the official performance of my duty as a police officer.
SIGNATURE DATE SIGNATURE ID# UNIT
RECEIVED BY REASON DATE/TIME RECEIVED
EFTA00077917