F-3(LE), Charges, Continued, Rev. 6/11
Applicant Name: ______________________________________________________________________________
D. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
E. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
F. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
G. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
H. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
I. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
J. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
K. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
L. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
M. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
N. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
O. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
P. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
Q. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
R. Offense Charged ___________________________ Law Enforcement Agency _____________________
Date ___________________________ Disposition of Case _____________________
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