Last updated: 5/3/2006
LEADS Entry Guide - McHenry County Sheriff - Service Data Sheet
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Description
LEADS ENTRY GUIDE McHENRY COUNTY SHERIFF - SERVICE DATA SHEET Case Number: ____________________ Issued: ________________ Expires: _______________ Respondent Name: ___________________________________ DOB: ____________ Sex: ___________ Race: ______ HGT: ______ WGT: ______ Hair: _________Beard: ________ Eyes: _______ Moustache: ______ Identifying Marks: _________________________________ __________ Address: ______________________________________ Telephone: __________________ Location: ______________________________________________________________ ______ Employer: _____________________________________ Telephone: __________________ Working Hours: _______________Other Locations: _________________________ ________ Respondents Car: Make: ________ Model: _________ Year: ______Color: ______________ Registration: __________________________________________________________ _______ Remedies R01 R02 R03 R04 R05 R06 R07 R08 R09 R10 R11 R12 R13 R14 R14.5 R15 R16 R17 Describe:_____________________________________________ Petitioner/Pro- Name: ________________________________________ DOB: ______________________ tected Addr ess Address(es): ___________________________________ Phone #:___________ __________ Protected La st, First, MI Relationship Code Persons Name #1: _______________________________________ ____________________ (To include Name #2: _______________________________________ ____________________ Petitioners name Name #3: _______________________________________ ____________________ and relationship Name #4: _______________________________________ ____________________ to Respondent) Name #5: _______________________________________ ____________________ Name #6: _______________________________________ ____________________ Name #7: _______________________________________ ____________________ Name #8: _______________________________________ ____________________ Miscellaneous ________________________________________________________________________ ___ Include BHV ________________________________________________________________________ ___ Code (Armed, ________________________________________________________________________ ___ Suicidalor Both) LEADS #: _______________ Entry Time: _____: _____ Entry Date: _____/ _____/ _____ OPR: _______ Modifications: Entry Time: _____:_____ Entry Date: _____/ _____/ _____ OPR: ______ Relationship Codes: Boyfriend/Girlfriend (Dating) BG Child CH Child in Common (not married) CC Shared/common Dwelling CS Grandchild GC Grandparent GP In-Law IL Parent PA Personal Assit. or Caregiver PC Person w/Disability PD Step-child SC To Person w/Disability Person Resp. for High-Risk Adult PR Sibling (Brother/Sister) SB Spouse SE Step-parent SP Step-Sibling SS Ex-Former Spouse XS Other Related by Blood/M arriage OF
