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Get Lycoming Da Complaints Form

Irst Name) (M.I.) Telephone Home Work Address: (No. & Street) Date Crime Committed: (City) (State) Time Crime Committed: (Zip) Location Crime Committed: Suspect/Defendant #1: Name: Address: Telephone: Suspect/Defendant #2: Name: Address: Telephone: HAVE YOU REPORTED CRIME TO LOCAL POLICE: Yes No HAVE YOU CONSULTED AN ATTORNEY: YES NO NAME OF DEPARTMENT AND POLICE OFFICER: NAME OF ATTORNEY: TELEPHONE: DATE POLICE NOTIFIED: POLIC.

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