Full Name

Approx. time and date

Incident location

Force Type
Restraint
Incapacitating
Lethal

Perception of suspects actions
Passive
Active/Escape resistance
Assaultive/High risk
Life threatening

Police equipment used on suspect
Handcuffs
Baton
Taser
Firearm
Combat pistol Pistol .50 Remington 870P Micro SMG MP5 M4 Carbine Sniper
Other

Outcome of force
Release
Imprisonment
Hospitalisation
Escape
Death

Summary of the incident

Incident witnesses

Shift/Scene supervisor