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
16-145339
09/13/2016
0643
22 - Vergennes
Fatal Accident
Dale Dekorte
Parnell Ave NE / Bailey Drive NE
Rockford Ambulance and Lowell Fire
3
Jeep
Laredo
2012
Peter Andre Baculi
24
Lowell
MI
none
W/B
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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