VIOLENT GANG AND TERRORIST ORGS MEMBER
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10 JOHNSTON COUNTY E - 911 COMMUNICATION NCIC ENTRY FORM Violent Gang and Terrorist Organization Member Mandatory Fields , One Or More Of The Following Identifiers are needed AGENCY CASE DATA Originating Agency Name _____ _________________________________ Originating Agency Code ORI ______________________ Gang Terrorist Organization __ G _ _ ________ ______ _ Agency Case Number ______________________ Notify Originating Agency ______________________ D ate of Purge _ ____________________ Criteria For Entry ______________________ Original Offense Code ___ ___________________ Warrant Number ______________________ Caution Medical Conditions _ _ ___________________ _______________ GROUP DATA All info in this section are mandatory fields Group Name ________________________________________ _______________ _ _ Subgroup Name _ ________________________________________________________ ________ ______ _ PERSON DATA Name _ _________________________________________________ S ex __ _______________ Race _ ________________ Height _________________ Weight _ ________________ Hair Color _________________ Eye Color __ _______________ S kin Tone __ _______________ Date of Birth _ ________________ Date of Emancipation _________________ Place of Birth _ __________ _ _____ Scars Marks and Tattoos _ __________________________________ Social Security Number __ _______________ Mi scellaneous Number ______________________ FBI Number __ _______________ Finger Print Classification ______________________ License Number __ _____________________ State __________ Year _______ If number entered , list ST & YR ___ ___________________ VEHICLE DATA If Vehicle is added , all + info in this section are mandatory fields Vehicle ID Number __ _________________________________ + Make _____ ______________________________ Model _ __________________________________ + Style ___________________________________ Color ___ ________________________________ + Year of Manufacturer __ _________________________________ PERSON DATA LICENSE PLATE DATA If License Plate is added , all info in this section are mandatory fields License Plate _ __________________________________ State ___________________________________ Year _ __________________________________ Type _ __________________________________ _________________ Information Date __________ _________________ NIC # ________ __ ___________________ Officer _ __________________________ Operator __________ __ _________________Page