M.N.P.D. Form 104E Supplement Exceptional Clearance Est. 06/12 ver 1.1 Supplement Exceptional Clearance This form is to be used to Clear an Incident by Exception November 15, 2017 INCIDENT NUMBER 20170966115 ARREST NUMBER VICTIM NAME OFFENSE DESCRIPTION FORCIBLE SODOMY PART I CURRENT STATUS Open UCR CASE STATUS Mark One Only Cleared by Exception DEATH of the OFFENDER PROSECUTION DECLINED EXTRADITION DECLINED REFUSED to COOPERATE (Victim) JUVENILE, NO CUSTODY (The handling of a juvenile without taking him/her into custody, but rather by oral or written notice given to the parents or legal guardian in a case involving a minor offense - e.g. Juvenile Citation) The investigation has definitely established the identity of the offender There is enough information to support an arrest, charge and turning over to the court for prosecution The exact location of the offender is known, so the offender could be taken into custody There is some reason outside law enforcement control that prevents the arrest, charging and prosecution of the offender
PART II Supplement Exceptional Clearance SUSPECT INFORMATION Note: In order to clear a case in UCR, the suspect data must match the arrestee data in all categories below. If suspect data on the original incident report matches the arrestee in all areas, you will not need to complete this section. SUSPECT INFO Suspect Name/Arrestee Info ARRESTEE INFO UPDATE SUSPECT WITH ARRESTEE CREATE SUSPECT WITH ARRESTEE New Suspect Info ADD NEW SUSPECT LAST NAME UPDATE UNKNOWN SUSPECT FIRST NAME DOB SEX RACE ETHNICITY Victim to Suspect Relationship (Personal Offenses) VICTIM NAME RELATIONSHIP Add Victim Delete Victim PART III NARRATIVE (REQUIRED) THE VICTIM WAS INTERVIEWED AND THE DATES HE GAVE FOR THE INCIDENTS ARE OUT OF THE STATUTE OF LITATIONS FOR PROSECUTION.
Supplement Exceptional Clearance EBS # 226676 LAST FLENG Reporting Officer FIRST CHARLES W DATE 11/15/2017 TIME 0721 HRS. Approving Supervisor EBS # 483526 LAST ROHWEDER FIRST SHAUN W EBS # 208864 LAST EDWARDS Records/Data Entry FIRST SARA L DATE 11/15/2017 TIME 1927 HRS. Validate
M.P.D FORM 100 (Rev. 5-00) CALEA 42.2.4, 82.2.1, 82.2.4 Part 1 Incident Incident Report 2. Related Incident 3. Other Police Agency & Case Incident No. Metropolitan Police Department Nashville, Tennessee ZONE 4. Report Type 5. Report Date/Time 6. Incident Date/Time (From/To) OTHER 11/07/2017 10:07 01/01/2008 00:00-12/31/2008 00:00 335 R.P.A. 8909 1. MPD Incident No. Precinct South Precinct 7. Reporting/Dispatched Location 749 MASSMAN DR UNK Apt No City State TN Zip Code 8. Address of Incident 3573 COUCHVILLE PIKE Same as Block No 7 Apt No City HERTAGE State TN Zip Code 37076 V # 1 9. Offense CODE 11B 10. Offense Description FORCIBLE SODOMY 11. Status COMPLETED 12. Location Type CODE RESIDENCE, HOME 13. Weapon CODE (Enter up to 3) PERSONAL (HANDS, ETC.) 15. Hate Crime 16. Suspected 16a. Terrorism Suspected NO Gang Activity NO Suspected NO 17. (For Burglary) Forced Entry If Hotel/Motel/rental Storage No. of Premises Entered 18. (For Burglary/Robbery) Home Invasion? Part 2 Victim No. 1 31. Victim Type 19. (Last, First, Middle Name or Business Name) UNK MNI 57829237 Individual (18 and over) 20. SSN UNK 21. Driver License (State (Number) UNK Same as Address of Incident (Block #8) 22. Address of Victim Street UNK Apt No City State Zip Code E-Mail Address Cross Street 23. Sex 24. Race 25. Ethnicity 27. County Resident 28. DOB UNK 29. Age MALE WHITE No 31 - Years 29. Phone Numbers HM: 30. Victim of Offenses: 11B (Ref Block #9) 32. Local College Student? (If Yes, List Name of College/University) WK: Cell/ Pager: 33. Employment (Name) (Address) (Apt No MNI (Cross Street) (City) (State) (Zip Code) (Email Address) 34. Domestic Disturbance? If Yes, Answer the Following Questions Was Order of Protection Violated? Was Victim taken to Safe Place? Were Children taken to Safe Place? Were Children Present During Incident? 35. Victim to Suspect 1 WEBSTER, KIRT Relationship VICTIM WAS FRIEND 36. Aggravated Assault/Homicide Circumstances 37. Negligent Manslaughter 38. Justifiable Homicide
Incident Report M.P.D. Form 100 Part 3 92. (Last, First, Middle Name) 94. SSN or Driver Lic. No. Alias UNK MNI 57272531 Suspect # 1 93. Address Street 3573 COUCHVILLE PIKE WEBSTER KIRT DL UNK Apt # 97. Sex 98. Race 99. Ethnicity 100. DOB UNK 101. Age City HERTAGE MALE WHITE NON HISPANIC OR L State TN 128. 08/07/1974 43 Page 2 of 4 Zip Code 37076 - V 1. M.P.D. Incident No.: 95. Phone No. UNK UNK 104. Height Yrs ' " 5 11 105. Weight 225 lbs 106. Hair BLOND OR STRAWBERRY 107. Eyes BLUE 108. Scars and Other Identifiers 109. Clothing 102. Suspected of Using NA 103. Status (Enter up to 2) Alcohol No Drugs No Computer No AT LARGE 96. Weapon/Tool (Enter Up To 3) 110. Vehicle Used PERSONAL (HANDS, ETC.) None Seized (If seized, complete Part 5, Motor Vehicle Section) MVI (Year) (Make) (Model) (Style) (Color) (License No.) (State) (Yr) Part 4 Other Person # 1 39. Other Person Type (Non-Victim) 40. (Last, First, Middle Name) MNI 41. Address Street UNK Apt No. City State Zip Code 42. Place of Employment/School UNK 43. Status 44. Sex 45. Race 47. DOB UNK 46. Age UNK 48. Phone HM - Yrs Numbers WK Cell/Pager Part 5 Property 49. Victim/Suspect No. 50. Cat CODE Category (Other) 51. Property Description (Make) (Model) (Size) (Type) (Color) 52. Serial No. Owner Applied No. 53. QTY 54. Type CODE 55. Cond CODE Condition CODE (Other) 56. Est $ Value 57. Date Recovered Recovered $Value 58. Stored By CODE Stored By (Other)
Incident Report M.P.D. Form 100 Part 6 Injury & Transport 86. "Injury" Code (Enter Up to 5) NONE 85. Injured Victim 1 128. Page 3 of 4 1. M.P.D. Incident No.: 87. Describe Injury NONE 88. Medical Treatment 89. Transported By 90. Examining Physician 91. Status Part 7 Search By Officer 111. Search Type 112. Searched Location (Address, Area, Etc.) Part 8 Other Units Requested 114.Other Units Called: 113.I.D. Section Called To Scene: Yes, for: Photos Prints Other Other: DNA Firearms Brass Casings Part 10 Narrative 120. THE VICTIM WAS INTERVIEWED AND DISCLOSED AN INCIDENT IN 2008 WHERE THE SUSPECT USED COERCION TO PERFORM FELLATIO ON THE VICTIM. THE VICTIM STATES THE FELLATIO WAS DONE AGAINST HIS WILL. THIS TOOK PLACE AT THE SUSPECT'S RESIDENCE. DUE TO THE STATUTE OF LITATIONS FOR THE INCIDENT HAVE EXPIRED THE CASE IS NOT BEING PROSECUTED. VICTIM UNDERSTOOD THE STATUTE OF LITATIONS HAD EXPIRED AND KNEW THE SUSPECT COULD NOT BE PROSECUTED AT THE TIME OF THE INTERVIEW. 121. Report is Continued on: (Check all that apply) Supplement Report Addendum Report 122. Signature of Recipient/Authorizer: Victim 1 Refuse to Sign RICK, AUSTIN 126. Advisory Notice Issued Will Victim Prosecute: Victim 1 No Primary Investigative Unit: SEX CRIMES Can Victim/Other Person Identify Suspect(s): Reporting Agency: Victim 1 Yes METROPOLITAN NASHVILLE POLICE DEPARTMENT 127. Case Status Cleared by Exception Open Cargo Theft 123. Reporting Officer (First,, Last) Employee No. Agency Radio Call Sign District /S/CHARLES FLENG 226676 TN0190100 3142A 124. Approving Supervisor Employee No. Agency /S/SHAUN ROHWEDER 483526 TN0190100 125. Reviewer Employee No. Agency Date /S/JAMES MARTIN 266974 TN0190100 11/08/2017
Incident Report M.P.D. Form 100 Comments 128. Page 4 of 4 1. M.P.D. Incident No.: Crime Scene Photo(s) Taken: NO