2. Agency
3. Date
   Date
5. Originating Routing Identifier (ORI)
7. Officer
9. Originating Case Agency (OCA)
11. Type
    -- Select One --EntryClearanceModification
13. Reporting Party Information
15. First Name
16. Last Name
18. Address
20. City
21. State
22. Zip Code
24. Phone Number
28. Entry Information
30. Stolen Vehicle / License Plate
32. Type

    1. Stolen License Plate
    2. Stolen Vehicle
33. Theft Date
    Theft Date
35. Make
36. Year
38. Model
39. Color
41. Vehicle Identification Number (VIN)
42. License
44. License State
46. Stolen Gun
48. Theft Date
    Theft Date
50. Serial
52. Type
54. Model
55. Caliber
57. Stolen Article
59. Theft Date
    Theft Date
60. Serial/Owner Applied Number (OAN)
62. Type
63. Brand
65. Persons
67. Type

    1. Missing Person
    2. Wanted Person
69. Date
    Date
71. First Name
72. Last Name
74. Date of Birth
    Date of Birth
75. Race
76. Height
77. Weight
79. Sex
80. Skin
82. Offense
84. Extradition

    1. Full
    2. Limited
    3. None
86. Stolen Boat
88. Theft Date
    Theft Date
90. Make
91. Year
93. License
94. State
96. Hull Number
97. Color
99. Length
103. Miscellaneous Information
105. National Instant Check (NIC) Number
107. Completed by
108. ID Number
110. Secondary review
111. ID Number
Leave This Blank:


112. Print Only

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