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Get IL ISP 4-1 2000-2024

T.: 5. Address of Incident: 6. Date Reported to DII: 7. County of Incident: 8. SUBJECT 9. VICTIM a. Name: a. Name: b. Address: b. Address: c. Rank/ID: c. Race: d. Race: d. Sex: e. Sex: e. DOB: f. DOB: f. SS#: g. SS#: g. Telephone: h. Work Location: 10. Requesting Agency: 12. Initiated by: 11. Requesting Officer/Manager: Division Public NARRATIVE (Description of Incident) 13. Supporting Documents? Yes______ No______Attached______ 14. Witnesses Yes______ No______ 15. Wh.

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