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EVERE'i i POLICE DEPARTMENT S7ATEMENT FORM <br />• CASE# DD'IS- <br />I�,.�as PA�..V-Ge� � "^`I lk�x�'S�;. l On..s�J� �kY�O�til� p-1i o�f OF- lh�L.dalCU�••A <br />917 A V=N�n-tJ. ,i� 'rYaaT Pa.�tl II.�SI L���' �'`f- �� �la/l, p� t1.M� t,�P o�'� <br />'S1YiFi � W �ti', On1 OnITo ML' ��D(�-�Y-• � � . <br />THIS STATEMENT WAS WRITTEN ON MY BEHA�F BY: <br />I DECLARE UNDER THE PENALTY OF PERJURY UNDER THE LAWS OF THE STATE Of WASFIINGTON THAT THE <br />FOREGOING WRITTEN STATEMENT, CONSISTING OF _L PAGES, IS TRUI HrUL AND ACCLRATE TO THE <br />BEST OF MY PERSONAL KNOWLEDGE. EACH PAGE AND ALL CORREGTIONS, IF ANY, BEAR MY INITIALS. <br />i HAVE READ �Jl j HAVE BEEN READ [? THE FOREGOING DECLARA DERSTAND THAT <br />DOCUMENT MAY BE USED IN A COURT OF LAW. �"� 1 �� �� � <br />� e.��, <br />�'��MAMSIGNANRE) . � �VIRNFSSSIG'�17L�l) <br />/ <br />FvF�z�T �✓A <br />(C INDSTA7ENM1�FAESw^NFD) <br />Pzge of <br />(INIT.j __ <br />ro-ow w: �aau <br />