# PALM BEACH POLICE DEPARTMENT
PROPERTY RECEIPT

PBPD Form #52

CONTRIBUTOR'S COPY

[ ] PROPERTY [ ] FOUND [ ] DECEASED (Probated) [ ] PERSONAL [ ] CONFISCATED [ ] DESTROY

[ ] EVIDENCE [ ] TRIAL [ ] LABORATORY [ ] STOLEN/RECOVERED [ ] OTHER

INCIDENT/CITATION NUMBER: 05-368
DATE/TIME RECOVERED: 10/8/21
PROPERTY NUMBER (Leave Blank): <empty>
BIN NUMBER (Leave Blank): <empty>

ADDRESS WHERE PROPERTY IMPOUNDED: [REDACTED] WEST PALM BEACH FL 33011

DISCOVERED BY / D.O.B.: <empty>
ADDRESS Street: <empty>
City: <empty>
Zip: <empty>
PHONE NUMBER: <empty>
OWNER'S NAME / D.O.B.: Palm Beach Police Dep
ADDRESS Street: <empty>
City: Palm Beach
Zip: 33408
PHONE NUMBER: <empty>
SUSPECT'S NAME / D.O.B.: <empty>
ADDRESS Street: <empty>
City: <empty>
Zip: <empty>
PHONE NUMBER: <empty>
ADDT'NL. SUSPECT / D.O.B.: <empty>
ADDRESS Street: <empty>
City: <empty>
Zip: <empty>
PHONE NUMBER: <empty>
SPECIAL INSTRUCTIONS: <empty>
FOUND PROPERTY CLAIM: [ ]
90 DAYS
NOT CLAIM: [ ]

<table><tr><th>ITEM I</th><th>QUANTITY</th><th>VALUE</th><th></th><th>DESCRIPTION</th></tr><tr><td></td><td></td><td></td><td>Bon</td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td>TOTAL PACKAGE WEIGHT</td><td></td></tr></table>

I hereby acknowledge that the above list represents all property taken from me and that I have received a copy of this receipt.
SIGNATURE: <signature>
DATE: 10/8/21

I hereby acknowledge that the above list represents all property impounded by me in the official performance of my duty as a police officer.
SIGNATURE: <signature>
ID#: 756
UNIT: Court

RECEIVED BY:<empty>
REASON:<empty>
DATE/TIME RECEIVED:<empty>
RECEIVED BY:<empty>
REASON:<empty>
DATE/TIME RECEIVED:<empty>
RECEIVED BY:<empty>
REASON:<empty>
DATE/TIME RECEIVED:<empty>
RECEIVED BY:<empty>
REASON:<empty>
DATE/TIME RECEIVED:<empty>

EFTA00039256