MISSING PERSON SUPPLEMENTAL
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10 JOHNSTON COUNTY E - 911 COMMUNICATION NCIC ENTRY FORM Missing Person Supplemental Form AGENCY CASE DATA Originating Agency Name ______________________________________________________________ Originating Agency Code ORI ______________________________________ RECORD IDENTIFYING DATA NCIC Number NIC _______________________________________________________ Agency Case Number OCA _________________________________________________ Name NAM _____________________________________________________________ Name PIN ______________________________________________________________ SUPPLEMENTAL PERSON DATA Alias PAK ____________________ ___________________________________________________________________ Date of Birth PIB ___________________________ Alias PAK _______________________________________________________________________________________ Date of Birth PIB ___________________________ Alias PAK _______________________________________________________________________________________ Date of Birth PIB ___________________________ Scars Marks and Tattoos PSM _______________________________________________________________________ Social Security Number PSS ______________________ _________________________ ______________________ Test Indicator Yes No __________________________ Information Date ___________________________ NIC # _____________________________ Officer ___________________________ Operator _____________________________Page