Fill and Sign the State Property Incident Report Sbi 78 Form North Carolina

Copy Of Police Report A t t ached Count y A nd Cit y List st olen or damaged it ems on rev erse side (Ov er) Signat ure Of Direct or, A dminist rat iv e Of f ice Of The Court s No Yes Embezzlement Thef t STATE OF NORTH CAROLINA Judicial Branch Of Government STATE PROPERTY M ISUSE REPORT FOR SBI INSTRUCTIONS: SEND: Signat ure Of A ssist ant Direct or A ssigned To A ssigned To Gov ernment al Inv est igat ions Unit . Filed - Inv est igat ion Handled By Local Depart ment Ot he r Complet e and f orw ard along w it h copy of t he police report , if av ailable. This report must be sent w it hin t hree day s of t he receipt of inf ormat ion regarding misuse of propert y . If t he v iolat ion inv olv es misuse of money in any w ay , immediat ely not if y t he Direct or of t he A dminist rat iv e Of f ice of t he Court s by t elephone. Fax a copy to (9 1 9 ) 7 1 5 -5 7 7 9 , Attn. : Director Send the original by courier to: Director Admininstrative Office of the Courts Raleigh, N. C. Courier # 5 6 -1 0 -5 0 BRIEF DESCRIPTION OF INCIDENT (A t t ach addit ional sheet if necessary . ) Dist rict For Inv est igat ion A nd/ Or A ppropriat e A ct ion. Signat ure Of Report ing Of f icial A rson Damage M isuse A OC-A -9 0 2 M , Rev . 6 / 0 2 2 0 0 2 A dminist rat iv e Of f ice of t he Court s FOR SBI USE ONLY $ Depart ment A mount Dat e Of Incident Name Of Local Law Enf orcement A gency Report ed To Person Report ing Inf ormat ion Propert y Inv olv ed Of f ice Or J udicial Of f icial Ty pe Of Crime Time Incident Dat e Dat e Receiv ed Dat e SBI File Number Report Receiv ed Dat e STOLEN OR DAM AGED PROPERTY Qty Items State Equip. No. Serial No. M odel Color V alue Total V alue A OC-A -9 0 2 M , Rev . 6 / 0 2 2 0 0 2 A dminist rat iv e Of f ice of t he Court s 0.00