Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • Alcohol Influence Report

Get Alcohol Influence Report

- ALCOHOL INFLUENCE REPORT FORM type name of police department here Defendant (First name) Age (Initial) Sex (Last name) Weight Eyes Case Number Sequential File No. Arrested by CHEMICAL BREATH TEST.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the Alcohol Influence Report online

The Alcohol Influence Report is a crucial document used in cases involving alcohol-related incidents. This guide provides step-by-step instructions to help you complete the report accurately and efficiently online.

Follow the steps to complete the Alcohol Influence Report online.

  1. Click the ‘Get Form’ button to access the Alcohol Influence Report. This action will open the form in your browser for editing.
  2. Begin by filling out the top section of the form, which includes information about the defendant. Enter their first name, last name, age, initial, sex, weight, eye color, case number, and sequential file number.
  3. Next, in the 'Arrested by' section, provide the name of the law enforcement officer or department involved in the arrest.
  4. Proceed to fill in the chemical breath test information. Select the type of breathalyzer used (either Model 900 or Model 900A) and enter the instrument serial number. Additionally, input the lot number for the ampoule control.
  5. Document the purge result percentage and the samples taken, including the date and time of each sample.
  6. For blood alcohol levels, record the results for each test conducted (up to four tests). Indicate the results in the designated spaces provided.
  7. In the 'Breathalyzer Check List,' ensure all applicable boxes are marked with an 'X' or checkmark, following the checklist phases: Set Up Phase, Preparation Phase, Purge Phase, and Analysis Phase.
  8. For the verification of the breath test operator, complete the sections for their rank, signature, badge number, date, and time.
  9. Finally, review all information entered for accuracy. You can then save your changes, download, print, or share the completed Alcohol Influence Report as necessary.

Complete your Alcohol Influence Report online today for a streamlined and efficient filing process.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

Alcohol Influence Report - Missouri Office of...
ALCOHOL INFLUENCE REPORT. (REV. 08-2018). DATE OF ARREST OR CUSTODY (MM/DD/YYYY) TIME OF...
Learn more
DUI Report Writing: Best Practices for Completing...
DUI Report Writing: Best Practices for Completing the DUI Alcohol/Drug. Influence Report...
Learn more
Long-term effects of alcohol - Wikipedia
Heavy consumption of ethanol (alcohol abuse) can cause severe detrimental effects. ... A...
Learn more

Related links form

Unconditional Form Of Property Ownership Daance Certification Reduced Fare Program - COTA Certificate Of Authorization Application - College Of Physicians And ...

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

Behavioral signs of alcohol or drug abuse Missing money, valuables, prescription or prescription drugs, borrowing and stealing money. Acting isolated, silent, withdrawn, engaging in secretive or suspicious behaviors. Clashes with family values and beliefs.

If someone is under the influence, their mind is affected by alcohol or drugs. [informal] Police charged the man with driving under the influence. Synonyms: drunk, tight [informal], smashed [slang], canned [slang] More Synonyms of under the influence.

The report bears a sequential number that is automatically generated by the Alcotest once the machine is put into operation. The operator must then input background information regarding the accused including his or her name, date of birth, height and weight, and drivers license number.

If a person is under the influence of alcohol, the person has consumed some intoxicating beverage in such a quantity, whether small or great, to cause an adverse effect on their actions, reactions, conduct, movement or mental processes, or impairs their reactions to an appreciable degree, thereby lessening their ...

If someone is under the influence, their mind is affected by alcohol or drugs. [informal] Police charged the man with driving under the influence. Synonyms: drunk, tight [informal], smashed [slang], canned [slang] More Synonyms of under the influence.

Under the influence means that you've consumed some alcohol, whether mild or potent, basically, weak or strong, that has appreciably impaired your mental faculties and essentially your ability to operate a motor vehicle.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Alcohol Influence Report
Get form
  • Adoption
  • Bankruptcy
  • Contractors
  • Divorce
  • Home Sales
  • Employment
  • Identity Theft
  • Incorporation
  • Landlord Tenant
  • Living Trust
  • Name Change
  • Personal Planning
  • Small Business
  • Wills & Estates
  • Packages A-Z
  • Affidavits
  • Bankruptcy
  • Bill of Sale
  • Corporate - LLC
  • Divorce
  • Employment
  • Identity Theft
  • Internet Technology
  • Landlord Tenant
  • Living Wills
  • Name Change
  • Power of Attorney
  • Real Estate
  • Small Estates
  • Wills
  • All Forms
  • Forms A-Z
  • Form Library
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
  • Real Estate Handbook
  • All Guides
  • Notarize
  • Incorporation services
  • For Consumers
  • For Small Business
  • For Attorneys
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Form Packages
  • Adoption
  • Bankruptcy
  • Contractors
  • Divorce
  • Home Sales
  • Employment
  • Identity Theft
  • Incorporation
  • Landlord Tenant
  • Living Trust
  • Name Change
  • Personal Planning
  • Small Business
  • Wills & Estates
  • Packages A-Z
Form Categories
  • Affidavits
  • Bankruptcy
  • Bill of Sale
  • Corporate - LLC
  • Divorce
  • Employment
  • Identity Theft
  • Internet Technology
  • Landlord Tenant
  • Living Wills
  • Name Change
  • Power of Attorney
  • Real Estate
  • Small Estates
  • Wills
  • All Forms
  • Forms A-Z
  • Form Library
Customer Service
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
Legal Guides
  • Real Estate Handbook
  • All Guides
Prepared for you
  • Notarize
  • Incorporation services
Our Customers
  • For Consumers
  • For Small Business
  • For Attorneys
Our Sites
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
© Copyright 1999-2026 airSlate Legal Forms, Inc. 3720 Flowood Dr, Flowood, Mississippi 39232
  • Your Privacy Choices
  • Terms of Service
  • Privacy Notice
  • Content Takedown Policy
  • Bug Bounty Program