1.
TYPE
OFFENSE/INCIDENT REPORT
INSTRUCTIONS ARE PRINTED SEPARATELY. IF ADDITIONAL SPACE x a. ORIGINAL b. CONTINUATION c. SUPPLEMENT
IS NEEDED, USE REVERSE OF FORM; IDENTIFY ITEMS. OR FOLLOWUP
2. CODE NO. 2a. SORT 3. TYPE OF OFFENSE OR INCIDENT 4. CASE CONTROL NUMBER
269 596 Multiple Gun Homicide
256985
5. BUILDING NUMBER 6. ADDRESS
N/A Martin Luther King Blvd
7. NAME OF AGENCY/BUREAU 8. AGENCY/BUREAU CODE 9. SPECIFIC LOCATION 10. LOCATION CODE
BDPD BDPD Brandenburg High-school 2568
11a. DATE OF OFFENSE/INCIDENT 11a. TIME OF OFFENSE/INCIDENT 12. DAY 13a. DATE REPORTED 13b. TIME REPORTED 14. DAY
5/1/2017 10:00am-2:00pm 1 5/1/2017 11:00am 1
15. JURISDICTION (X) 16. NO. OF DEMONSTRATORS 17. NO. EVACUATED a. TIME START b. TIME END
x EXCLUSIVE CONCURRENT PARTIAL PROPRIETARY 1 256 10:00am 2:00pm
ID CODE NAME AND ADDRESS AGE SEX RACE INJURY CODE TELEPHONE
(a) (b) (c) (d) (e) (f) (g)
Last Name, First, Middle Initial HOME
17 M W N/A
18. PERSONS
Hoffman, Jacob, Daniel 555-4589
INVOLVED
Number, Street, Apt. No., City and State BUSINESS
23 Cedar Lane Dr
Last Name, First, Middle Initial HOME
Number, Street, Apt. No., City and State BUSINESS
b. YEAR c. MAKE d. e. COLOR (Top/Bottom) f. IDENTIFYING CHARACTERISTICS
MODEL
19. VEHICLE
a. STATUS
STOLEN SUSPECT YEAR STATE TAG NO. h. VIN i. VALUE
GOVT
VANDALIZED
x PERSONAL
RECOVERED
g. REGIS-
TRATION
a. NAME OF ITEM b. QUANTITY c. OWNERSHIP d. BRAND NAME
AK-47 12 Gauge Springfield Shotgun 1 GOVT x PERSONAL Springfield
e. SERIAL NO. f. COLOR g. MODEL
25698564752315 Gray And Black 469Charlie45
h. VALUE i. UNUSUAL OR UNIQUE FEATURES
8,000$ Dog Tags on trigger cuff
20. ITEMS TAKEN
j. PROPERTY WAS k. STATUS OF PROPERTY VALUE RECOVERED
x SECURRED UNSECURED x RECOVERED MISSING PARTIAL RECOVERY
8,000
l. NAME OF ITEM m. QUANTITY n. OWNERSHIP o. BRAND NAME
Airman 12 Gauge Shotgun 1 GOVT
x PERSONAL Airman
p. SERIAL NO. q. COLOR r. MODEL
25648136958462 Black 25462
s. VALUE t. UNUSUAL OR UNIQUE FEATURES
$4,000 None
u. PROPERTY WAS v. STATUS OF PROPERTY VALUE RECOVERED
x SECURRED UNSECURED x RECOVERED MISSING PARTIAL RECOVERY $4,000
21. NARRATIVE (If additional space is needed, use blank sheet and attach.)
Suspect Apprehended was Apprehended after a two hour standoff between swat and police
Suspect's Case will be going through all forms of government regarding the severity and national public media incurred
Suspect's Armaments will be taken into custody
Suspect Murdered 15 people and injured 40
256 people evacuated from school and were treated by officials on scene
GENERAL SERVICES ADMINISTRATION GSA FORM 3155 (REV. 3/200)
TIME 23a. EVIDENCE 23b. TAG NO. 23c. TYPE
22. NOTIFICATION
NOTIFIED ARRIVED YES NO
a. Other Police 23d. WHERE STORED
Agency 11:00am 11:13am
24. ATTACHMENTS (Mark X where applicable)
b. Fire Department
a. CONTINUATION SHEET
d. STATEMENT(S)
b. GSA FORM 3157
c. Ambulance 11:05am 11:15am c. PROPERTY RECEIPT(S) e. SUPPLEMENTAL
f. OTHER ATTACHMENTS (Specify)
d. Building Manager
e. OTHER (Specify)
11:02am 11:20am
Swat
25. SUSPECT STATUS 26. DISPOSITION OF SUSPECT
a. NOT IDENTIFIED x x a. ARRESTED b. NOT ARRESTED
b. GOVERNMENT EMPLOYEE c. RELEASED d. N/A
c. GOVERNMENT CONTRACT CITATION NUMBER
d. NON-GOVERNMENT EMPLOYEE x d. CITATION ISSUED (Being Withheld)
e. N/A
NOTE: Complete GSA Form 3157 where this is a Suspect, Att. Burglary, Burglary, Att. Robbery, Robbery, or a Weapon is used.
27. TIME 28. REVIEWED BY
a. RECEIVED b. ARRIVED a. TYPE b. SIGNATURE d. DATE
10:30am 10:00am x FPS Sheriff Peters 4/1/2017
c. RETURNED TO SERVICE c. NAME (Printed)
x GG
yes Sheriff Peters
29a. BADGE 29b. NAME (Printed) 29c. SIGNATURE 29d. DATE
C37 Peter S Adams Peters stuy
30. CASE REFERRED TO 32. APPROVING OFFICIAL
31. CASE
a. FPS DETECTIVE b. LOCAL POLICE c. STATE POLICE a. SIGNATURE b. DATE
d. FBI x e. IG x f. N/A a. OPEN Officer Jordan 5/1/2017
x x
g. OTHER (Specify) b. CLOSED c. NAME (Printed)
c. UNFOUNDED Jordan Mcdowel
33. DETECTIVE STATUS
a. CASE NUMBER b. HOW CLOSED c. SUSPECT d. ENTERED NCIC
INACTIVE x ARREST OTHER MEANS DEVELOPED x ARRESTED YES NO N/A
f. VALUE OF PROPERTY g. CLEARED NCIC h. REFERRED TO
e. PROPERTY
x RECOVERED
$17,500 YES NO N/A i. DATE REFERRAL ACCEPTED
21. NARRATIVE (If additional space is needed, use blank sheet and attach.)
Police Received call from local High-school at 11;00 am about a potential shooting taking place. The shooter was identified as Jacob
Hoffman. Hoffman entered the school but wasn't a threat until around 10:30 to 11:00 o'clock am. Shooter opened fire as soon as
officials arrived on scene. Hoffman after two-four hours surrendered himself and police confiscated the weapons.
GSA FORM 3155 (REV. 3/200) PAGE 2
