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CENTENNIAL LAKES POLICE DEPARTMENT <br /> j VOLUNTARY STATEMENT <br /> `" <br /> Department Case Number _ V 1 Officer's Badge Number � <br /> fl iE 1 �D el in , Date of Birth: <br /> (Firs[) (M) <br /> Address: City/State: <br /> Home Phone: Wulf Phone: i <br /> do voluntarily give the following statement to the Centennial Lakes Police Department: <br /> 4t et* jraj 'sham L.a4 a1 & a4'4 al tostiresee !. tier for <br /> Watroaj !r(res Witt 404P-ortli» Oa J.11 jen a-P1 rare* <br /> o pet Lai t et tua 1;4Id . the Cca•1' L c1aw4 ri if,Q <br /> is 5ts.+ <br /> This statement, consisting of 1 pages, including corrections if any, which I have initialed, is true and <br /> correct to the best of my knowledge, <br /> Signed: Date: II /gJ tver <br /> r <br /> 111 '�`� <br />