Fillable OFFICIAL MEDIA RELEASE (Kent County, Michigan)

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OFFICIAL MEDIA RELEASE (Kent County, Michigan)

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OFFICIAL MEDIA RELEASE
KENT COUNTY SHERIFF DEPARTMENT
Incident # Date: Time of Incident:
Type of Incident:
Location:
Reporting Officer:
Release Completed By:
N
UNK
Y
ALCOHOL Contributing Factor?
Make: Model: Yr:
Veh:
Make: Model: Yr:
Driver:
Driver:
Age: Age:
.
City:
Twp: Twp:
State: State:City:
Seatbelt: Y
N
YNSeatbelt:Injuries:
Injuries:
Direction of Travel:
Direction of Travel:
Hospital: Transport By:
Transport By:
Hospital:
Relatives NotifiedRelatives Notified Names Can Be Released Names Can Be Released
Vehicles
Veh:
Helicopter
Fire
Ambulance Other Police Agencies Utilities etc.
Name:
Age:
City:
Twp:
State:
Seatbelt:
Injuries:
Hospital: Transport By:
Passengers
Name:
Age:
City:
Twp:
State:
Seatbelt:
Injuries:
Hospital: Transport By:
Name:
Age:
City:
Twp:
State:
Seatbelt:
Injuries:
Hospital: Transport By:
Name:
Age:
City:
Twp:
State:
Seatbelt:
Injuries:
Hospital: Transport By:
Name:
Age:
City:
Twp:
State:
Seatbelt:
Injuries:
Hospital: Transport By:
Name:
Age:
City:
Twp:
State:
Seatbelt:
Injuries:
Hospital: Transport By:
Name:
Age:
City:
Twp:
State:
Seatbelt:
Injuries:
Hospital: Transport By:
Name:
Age:
City:
Twp:
State:
Seatbelt:
Injuries:
Hospital: Transport By:
Passengers
N
UNK
Y
ALCOHOL Contributing Factor?
Assisting Departments:
Clear
18-158698
11/23/2018
2316
17 - Plainfield
Single vehicle fatal crash
Shattuck
West River Dr NE/Samrick Ave NE
Plainfield Fire, Rockford PD, Rockford Ambulance
1
Ford
F350
1999
CHADWICK PERRY KOGELSCHATZ
36
8875 Shaner Ave NE
Courtland
MI
W/B
YES
NO
Township:
UNK
UNK
701 Ball Avenue NE, Grand Rapids, MI 49503
Media Line (616) 632-6236
Traffic Crash Supplement
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OFFICIAL MEDIA RELEASE (Kent County, Michigan)

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Completed 20 November 2020

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