4-28/000.00 - Form Numbers and Titles



SH-AD-

1

Printing Request (3-02)

32A

Sheriff's Department Office Correspondence (3-08)

90

Affidavit of Loss of Identification (3-03; 4-05)

91

Employee's Personal Information (3-02; 3-03; 5-09)

92

Employer's Report of Occupational Injury or Illness (3-02; 4-19)

103

Special Appropriation Expense Claim (3-05)

121

Authority for Release of Property (5-04)

131

Memorandum (yellow half sheet) (3-05; 3-08)

136

Request for Approval of Outside Employment (3-02)

137

Request for Approval of Outside Teaching Employment (3-02)

173

Agreement Assuming Risk of Injury or Damage, Waiver and Release of Claims and Indemnity Agreement (Ride-Along Waiver) (3-09; 4-26; 5-09)

251

Overtime Worked Report (3-02)

267

Sheriff's Special bulletin (5-09)

271

Letter of Resignation (3-02)

274

Liquor License Application Investigation (4-15)

359

Transmittal for Miscellaneous Fees (5-04)

362

Equipment Check-Off Sheet (3-02)

455

Authorized Signature Time Record (3-02)

462

Bail/Fine Forms (3-05)

465

Formal Grievance (3-02)

477

Admonition and Waiver of Rights (5-07) (English and Spanish)

495

Prisoner Claim for Missing or Damaged Property (5-03)

516

Certificate of Release (5-03)

520

Administrative Service Statistics Card (4-06)

542

Patrol Car Observation Information Form (5-09)

543

Observer Ride - Along Comments Form (5-09)

575

Contract Law Enforcement Services (3-09)

591

Request for Approval of Training (3-02)

601

Change of Command (2-02)

602

Concealed Weapon License Application (5-09)

630

Shots Fired by or at Deputies (5-09)

648

Certification of Pregnancy (3-02)

651

Employee Report on Outside Employment Activities of Full-Time, Permanent County Employees (3-02)

658

Commendable Restraint Commendation (3-02)

659

Monthly Report of Blood Samples and Sexual Assault Evidence Collections (5-08)

665

Report of Vehicle Accident or Incident (3-09; 4-06; 4-19)

666

Industrial Illness/Illness Investigation (3-02)

668

Non-Employee Injury Report (4-19)

669

Personnel Investigation

670

Personnel Investigation Continuation

671

Request for Approval of Outside Security Employment

672

Claim for Damages to Person or Property

673

Occupational Injury or Illness

SH-J-

181

Inmate Special Handling Request (5-03)

212

Inmate Injury Report

268

Surety Bond Request for Release of Prisoner (5-03)

275

Bail or Fine Slip (5-03)

293

Booking and Property Record (5-02; 5-03; 5-04)

388

Good Time/Work Time Awards (4-19; 5-03)

SH-R-

2

Supplementary Report (Black-Cornered) (4-01; 5-09)

12

Missing Person Report (5-09)

49

Incident Report (5-01; 5-02)

49B

Crime Analysis Supplemental Report

77

Supplementary Report (Red-Cornered) (4-01)

84

Fire Field Report (5-01)

90

Notice of Claim of Ownership (5-09)

95

Check Report (5-09)

191

Runaway Juvenile/Combined Complaint Report and Emergency Broadcast

217

Index Card (5-09)

221

Complaint Report (Driving Under the Influence of Alcohol/Drugs) (3-09)

256

Vehicle Repossession Report (4-16)

257

Supervisor's Report of Damage to County Vehicle or Permittee's Vehicle (3-09)

364

Motor Vehicle Traffic Collision Continuation Report

377

Alarm Incident Report (4-04)

381

Cattle Identification (4-15)

387

Ownership Claim (5-09)

388

Declaration of Ownership (5-09)

396

Hazardous Materials Incident Data Sheet (5-06)

397

Report of Assistance

400

Fireworks - Not For Prosecution Record (5-09)

410

Entry and Search Waiver (5-06)

426

Hazardous Materials Injury/Toxic Substances/Communicable Disease Exposure Report (4-06)

430

Vehicle Pursuit Summary

435

Additional Charges and Holds Record (5-09)

437

Watch Commander's Service Comment Report (3-04)

438P

Supervisor's Report on Use of Force (5-09)

441A

Officer Involved Shooting

441B

Officer Involved Shooting Continuation

443

Registration Application for 457.1.P.C.

443A

290 Registration

446

Extreme Intoxication Assessment Sheet - B

447

Extreme Intoxication Assessment Sheet - A

454

Pursuit Evaluation Form

474

Uniform Report Number (URN) Void Report (refer to section 4-02/080.00)

Miscellaneous

A-1

California Boating Accident Report (4-05)

BC Form 1-D

Good Samaritans Eligibility Form (5-09)

BC Form 100

State's Victim Compensations and Government Claims Board (BC) Victims of Violent Crimes Eligibility (5-09)

BCID 8270

Petition to Seal and Destroy Arrest Records (3-09)

BID 7

Concealed Weapon License Form, Bureau of Identification (5-09)

CHP 180

Abandoned, Impounded, Recovered, Stored, or Released Vehicle (4-01; 4-06; 4-16; 5-01;)

CHP 180F

Vehicle Forfeiture Report

CHP 181

Notice of Impoundment of Vehicle and/or Component Parts

CHP 181A

Notice of Hearing--Impoundment of Vehicle or Component Parts

CHP 187

Pursuit Report (5-09)

CHP 555

Traffic Collision Report (3-09; 5-05)

CHP 555-03

Traffic Collision Report - Property Damage Only (5-05)

DBW-SVR--5a

Stolen, Embezzled, Lost Vessel Report (4-05)

DBW-SVR-5b

Impounded, Recovered, Stored, Released Vessel Report (4-05) (Note: DBW-SVR-5a and 5b are printed on a back-to-back form)

DBW-VAR-1

Vessel Accident Report, California Department of Boating and Waterways

DS-360

Administrative Per SE Order of Suspension (5-05)

DMV DL 367

Officer's Statement, Section 13353 Vehicle Code (4-07)

20-MD91

Driver's Vehicle Condition Report (3-09)

DWC Form 1

Employees Claim for Worker's Compensation Benefits (3-02)

FD-249

Fingerprint Cards (5-03)

H-1561

Animal Bites (4-04)

JUS-8715

Arrest Disposition and Court Action Report (4-01)

LAFM - OPS500

Mechanical Defect Report (5-09)

MH-1533

Application for 72-Hour Detention for Evaluation and Treatment (4-16; 5-09)

6488-B

CYA Order Recall (5-02)

761472

In-Custody Medical Treatment Form (5-09)

76C109

Overage Report (5-03)

76C111

Cashier's Report or Receipt (5-03)

76C212D2m

Claim for Damages to Person or Property Form (AS-58-1) (4-06; 4-19; 5-01)

76C367

Change of Status Report (3-02)

76C622

Coroner's Inventory of Personal Effects of Deceased Person (4-03; 4-19)

76E482

Emergency Aid Plan (4-08; 5-09)

76E499-A

Emergency Ambulance Service

76E608J

Juvenile Hall Entrance Record (5-03)

76E928

Expense Claim (3-02; 3-05)

76M119F

Medical Service Order (3-02)

76P791-CR 37

Property Control Card (5-09)

76S908

Superior-Subordinate Pay Finding and Authorization (3-02)

76V80

Vehicle Damage Report (3-09)

Jury Form 3

Notice of County Employee Status (3-02)

Jury Form 4

Certificate of Jury Service (3-02)

SS 8567

Authorization For Seizure of Dental Records (5-09)