Officer Involved Shooting (OIS) Form SECTION 1: BASIC INFORMATION Date * MM DD YYYY Time * Hour Minute Second AM PM Location of Incident: * SBI Agent(s) Involved in Investigation: * SECTION 2: AGENCY & PERSONNEL INVOLVED Agency(s) and Personnel Involved: * San Andreas Highway Patrol Blaine County Sheriff's Office Municipal Police Department San Andreas Fire and Rescue Officer(s) who fired their weapon(s): * SECTION 3: SUBJECT(S) INFORMATION Name of Subject(s) * Subject(s) Status: * Uninjured Injured Deceased Unknown SECTION 4: INCIDENT OVERVIEW Summary of Incident: * Be very detailed. SECTION 5: EVIDENCE Does bodycam footage exist? * Yes No SECTION 6: CONCERNS OR ISSUES Concerns or Noteworthy Issues: (If applicable) SECTION 7: INVESTIGATOR CERTIFICATION I hereby certify that the information in this report is accurate and complete to the best of my knowledge at the time of submission. I Agree Thank you!
