<p>BNI-6 (Rev. 3/96) PERSONAL HISTORY/ARREST REPORT 1. USE (check applicable box): 2. Case Number 5. Fingerprinted ( ) Yes ( ) No</p><p>( ) Personal History ( ) Informant ID 3. OTN Number(s) 6. Probation ( ) Parole ( ) Where? </p><p>( ) Arrest Record ( ) Fugitive Declaration 4. Informant ID Number 7. NCIC Check ( ) Yes ( ) No Date:</p><p>8. Name (LAST, FIRST, MIDDLE) 9. Alias(es) or Other Name(s)</p><p>10. Permanent Address (include ZIP CODE) 10a. Telephone Number ( )</p><p>11. Other Address (if any) 11a. Telephone Number ( )</p><p>12. Date of Birth 13. Place of Birth (City/State) 14. Citizenship 15. Illegal Alien ( ) Yes ( ) No</p><p>16. Nationality 17. Race 18. Sex 19. Height 20. Weight 21. Eyes 22. Glasses 23. Hair ( ) M ( ) F (inches)</p><p>24. Build 25. Complexion 26. Identifying Characteristics (Scars, Marks, Tattoos, Etc.) 27. Drug User ( ) Yes ( ) No (If yes, list drug)</p><p>28. SSN # 29. FBI # 30. DEA # 31. SID # 32. Other Numbers (Federal, State, Local, etc.)</p><p>33. Employer/Address 34. Education 35. Vehicle Registration Information (Level/Name of School) Make/Model Year State </p><p>36. Driver's License Information: State or Country: License # Operator's License Number: Expiration Date: Expires:</p><p>7. Spouse: Address:</p><p>38. Immediate Family (Relationship): Address:</p><p>39. Address:</p><p>40. Address:</p><p>41. REMARKS: PA Megan’s Law Offender – ( ) Yes ( ) No”</p><p>42. Primary Officer: 43. Agency (BNI/PSP/TF/OTH):</p><p>44. Secondary Officer: 45. Agency (BNI/PSP/TF/OTH):</p><p>46. Reporting Date: 47. Date/Time of Arrest: 48. Where Arrested: 49. Occupation Code: (Municipal Code)</p><p>50. Class (1-4): 51. Type Violation: 52. Counts: 53. Drug Code:</p><p>54. Firearms: 55. Arrest by Result of: 56. Armed: ( ) Yes 57. Photographed: ( ) Yes (I)nvolved / (C)harged ( ) No ( ) No</p><p>58. Statement: ( ) Yes ( ) No 59. Funds at Arrest: 60. Other Controlled Substances/Drugs Involved: $</p><p>Officer's Signature/Date: Supervisor's Signature/Date: CODES FOR PERSONAL HISTORY/ARREST REPORT (BNI-6)</p><p>DRUG CODES OCCUPATIONAL CODES</p><p>CAN MAR Marihuana HWF Housewife</p><p>CAN CAN Other Cannabis LAB Laborer</p><p>DEP BAR Barbiturates MGR Manager</p><p>DEP DEP Other Depressants OFF Office Worker</p><p>HAL HAL Hallucinogens OPR Operative</p><p>HAL LSD LSD OTH Other</p><p>HAL PCP Phencyclidine PRO Professional</p><p>NAR CHW China White REG Registrant</p><p>NAR FEN Fentanyl SAL Sales</p><p>NAR HER Heroin SER Service Worker</p><p>NAR HYD Hydromorphone SKC Skilled Laborer</p><p>NAR ONA Other Narcotic STU Student</p><p>STI AMP Amphetamines TEC Technician</p><p>STI COC Cocaine UNE Unemployed</p><p>STI CRK Crack UNK Unknown</p><p>STI MTH Methamphetamines TYPE OF VIOLATION</p><p>STI STM Other Stimulants A12 Forgery (13-A-12)</p><p>STR ANA Anabolic A13 Maintaining a Drug Dependent Person (13-A- 13)</p><p>STR STR Other Steroids A14 Illegal Prescription or Dispensing for Non- Medical Reason (13-A-14)</p><p>DRL OTH Other Than Drug 699 Pharmacy Act</p><p>DRL PAR Paraphernalia CON Conspiracy (PCC 903)</p><p>DRL PRE Precursors DEL Delivery (13-A-30)</p><p>DRL THF Theft MFG Manufacturing (13-A-30)</p><p>MIS DD Designer Drugs OTH Other</p><p>MIS ODR Look-Alike Drugs POS Possession (13-A-16)</p><p>MIS NPD Non-Proprietary Drug PWI Possession with Intent to Deliver (13-A-30)</p><p>MIS PPD Proprietary Drug</p>