FL05 20800 UCN : 522 010MM026928XXXX NO

rSTS NUMBER ICOMPLAINT/ARRE S T AFFIDAVIT - CIR CUIT/C OUNTY COURT - PINELLA S CO UNTY, FLORIDA DOC KET II 14 2 4 6 5 4

FelonyL J Misde meanor ~ Ordinance o ..

Na n-Cri min a l 0 Wllrranl 0 Traffic.0 [.SEliiL 02280011 ~ 262-45-1 66 1 I
Cha rge BATTERY ; DOMES IIC I Re port No 10-01 0740 Court Case N°' CTC1 02 6 928 MM ANO

Defendant's Na me (Last, First, Middle) Sex e Ht.

R ILE Y , B RENDA M ARIE IDOB 04/14/1961 F Iw 509 1180 1SLN ISeLU ISFAR
Alias I Dri ver 's Lic e nse No. S ta te Scars, Tatto os , Unique Phy s i ca l Fe atures
TATT UPPER BA CK/LOWER BACK
Local Addr"" (S tr eet, City, State) Zip Cod e Te lephone Pla ce of Birth
IFicnshiP
301 N BELCHER RD #901 LARGO FL 33771 727-678-6455 IOWA
Pt:!rm a n ('n t A dd r~$ s (St r ee t , City, St ate ) Zi p Co de Te le p h one Em ploy ed by/School

Ty pe I Indica tio n 0 \ Y N UNK Ind i ca ti o n o f Mental Y N U NK Indic ation o f Y N UNK

Wea pon Se iz(·d
Ye. O N0 0 Drug Influen ce 0 00 Health Is sues 00 Alcoh o l Influenc e 0 E] O

0 U
Co-Defe ndant's Nam e (Las t, Fi rs t, Midd le)
DaL\ l~lO ~ DOB Sex R ace In Cus todYy(jes
Felon
No
Mis d. O
Co-D efend ant's Name (Las t. Firs t, Middle) DOB Sex Ra ce In Cus tody Y.s O No 0
FelonyD Mls d.O
The undNs igned s wear s that he has rc~ sonable ground s to be lieve that Ihe above name d defe nda nt o n t he ~ day of SEPTEivlBE R 2010
al p proximat e ly 12:01 AM at 301 N BELC HER RD # 901, LARGO, FL 3377 1 , in Pinellas County did :

Actually an d intentionally touch o r s trik e (KEANE LANGEL), (HER) (BOYFRIEND) and c o-habitant, against
the wi ll of (K EANE LANGEL) , to - wit: THE DEF WAS IN A N ALTERCATION WITH HER LIVE IN
B OY FRIE N D . THE VIC BEGAN SPITTING BANANA ON THE DEF AND THROW I NG DONUTS AT HER.
THE DEF GOT UPSET AND WENT AND A R MED HERSELF WITH A BANANA. SHE RIPPED THE
BA NANA IN 2 AND SMASHED THEM INTO THE VIC'S EARS.THE VIC AND DEF THEN CONTINUED
TO THROW FOOD AT EACH OTHER AND THE DEF FIN A LLY CALLED THE POLICE . THE DEF
STATED SHE SMASHED THE BANAN A I N TO THE DEF'S EARS BECAUSE SHE WAS MAD. THIS IS
DO M ESTIC RELATED BECAUSE BOTH PARTIES RESIDE TOGETHER AS A FAMILY .

Oth e r tra ffic cita t io ns _ _ __ _ _ __ _ __ _ _ _ _ _ _ __ _ _ _ _ _ Contrary to Florida S ta tutelOrdinan ce 784.0~ ______

ARREST DATE 9/29/ 201 0 Time 12.:3 7 AM Aggravating/Mitigat ing Factors
Boo king Offic er HVIZDZAK B 5436 Amount of Bo nd ZERO Bond Out Date Time am pm
Victim Notified of Advisory y[]N 0 Inj urf es to Victim U NO Med ical-Treatment to Vi c tim vOND
Child a bu s e/neglect refe rral made to DCF vOND REQUEST FOR INVESTIGATIVE COSTS , F.S . 938 .2 7(1)
DATE OFFICER HOURS X PAY RATE = COST
Pursuant to F.S. 92.525 nd under penalties of perjury. I declare tha t I have read the foregoing
docu me nt an d tha t the facts slated in it ar.. true.
OS/29/20 10 J.ZI MN Y 4 25 $ 100.00

~
Declarant
LARG O POLICE DEPT.
Agency
OTHE R - Descnbe
O FFI CER JU STI N ZI MNY 417 0 1402488 Conti nuation sheel {]NU
Printed Name SPN $100.00
TOTAL
Received by Booking: 9/29/ 20 10 1:38: 17 AM NOTICE TO APPEAR ONLY

o MISDEMEANOR - Yo u MUST ap pear at the Crimina l Jus tice Cente r. Counroom 15, Third Floo r, 14250 49th Stree t Nonh , Clearwater, Florida . on the _ _ _ _ _ day of
_ _ _ at _ _ _ _ _ __ __ _ __ _ _ _ __ _ _ _ _ _ a .m. p. m.
o A.ORDINAN C E VIOLATION - You MUST comply wil h EITHER A o r B:
Comply wilh th e Waiver Informatio n on the reverse side 01 th is form an d pay fi ne in the amo unt of S _ _ _ _ _ _ for a Categ ory offense
wi thin thirty (3 0) calenda r days of th is Nolice .
B. Appea r at the Criminal Jus Uce Center, 1 250 49th StJeet. Cou rt room 15. Third Floor. ClearNate r, Florida, on the _ _ day of _ _ _ _ _ _ _ _ _ _ __
. at a.m . p. m.
o NON-CRIMINAL VIOLATION - You MUST pay a fi ne in the amoun t of S _ _ _ _ _ _ _ within thi rty (30 ) ca lend a r days, or comply with the non-crimin a l 'i iol3tion
information on the bottom of the reverse s ide 01 this form.
I AGREE TO APPEAR AT THE TI ME ND P LAC E DESI GNATED ABOVE TO .o,N SW ER TH E OFFEN S E CHARGE D OR TO PAY TI-lE FI NE S UB S CRI BED. I UN DE RS TAND THAT
S HOULD I WILLFU LLY FAIL TO AP PEAR BEFORE THE CO URT AS REQU IRED BY THI S NOTICE TO APP EAR, OR PAY THE FI NE REQU IR ED BY THE DAT ES SET OU T ON
THIS FORM . THAT I MAY BE HELD IN CONTE MPT OF CO URT AND THAT A WARRAN T FOR MY ARREST WILL BE ISSU ED . I HEREBY CERTIFY BY MY S IGNATU RE THE
BELOW LI STED ADDRESS IS MY CORRECT ADDRESS .

Defencanfs Sign,. ture (strne~ Clly, te, Zip Code) Dale of Rece.ipt of alice
Copies 10:
122389
COCRS9 (Revised 12/06) Public Defender COCRS9 (A.b,c,d ) i 2106

9/2 9/ 2010