NEW ALBANY POLICE DEPARTMENT - New Albany, Ohio

Addendum D
Injuries Sustained by Suspect:
Not Wounded Superficial Critical Fatal Unknown
Was Suspect Hospitalized?
Yes No If yes, where:
Location and Type of of Suspect’s Injury:
Officer Involved:
Name:
Badge Number:
Rank:
Age:
Signature:
Date:
Witnesses (Including Backup Officers):
Name: (Last, First, MI) Address or Department Name: Phone Number:
PD-99-210
Revised February 2012 Page | 4