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ACTlCAL RESPONSE REPORT/Chicago Police Department 1. GATE OF INCIDENT TIME 2. AOORESS OF OCCURRENCE 3. LOCATION CODE 31-MAY-2011 22;4A;00 12355 S WALLACE S7 CHICAGO, IL 6U628 303 0523 Q 5. P0.SITION 8. LAST NAME 7. FIRST NAME 8. STAR N0. A. 3EX 10. R4CE COpE11. AGE 12. MT. 13. WT. J 9161 TALI MOHAMMED 7241 ~o~M ~osF API 507 150 74, DATE OF APPT. 15. EMPLOYEE N0. 18. UNIT &BEAT OF ASSIGNMENT 17. WTV STATUS 78,MEMBER INJURED? 18, MEMBER IN UNIFORMS z 25SEP-2006 153 05646 ~o~ o~ ~ oz on ~o~ r~ ~ az ra ~01 Yes [~ ae ra ---20, ST NAME 21. FIRST NAME 22.M.1. 23. SEX 14, RACE 25.0,0.8. 28. NT. 27. NT. ~+^ CALVIN CROSS ~o~rn rlozF BLK z 28. ADDRESS CHICAGO, IL 29.TELEPHONE NO. 30.WAS SUBJECT ARMED?FNiEARM •REVOLVER, 31. SUBJECT INJURE? 32.SUBJECT ALLEGED INJURY? OTHER (9PECIFI~ Q ~ 01 Yes q 02 No ~0 1 Yes ~0 2 No ~ Ot Yes ~ p2 No ~ 33. WHERE WA3 MEDiCAL.7REA7MEN7OBTALNED? 34, BV WHOM? S. CONDITION ~ ~~ ~~~~y ~B~ ~ 02 Untler Influence O PRONOUNCED ON SCENE BY ME L7 o3~wxaizac []o ar~~H~~errsa ~ osaa+~aan~ai~a,nw ? 38. CHARGES PLACED ~ pHq 37. CBNO. IR NO, q ~ 3B. PA99NE RESISTER ACTIVE RE9187ER A89AIUHT:A99I1ULT g0SAR1~NT:BATTERY A99AILgNT;OEADLY FQRCE ~N,_~qI FN 0V1E0R BNAOLT D FIORLELCOTIWO N ~ F~E~ ~ ~f.MA~NENT THREAT ~ ATTACK WITH WEAPON ~ ~~~ p~TM~IK~ELY TO OF BATTERY U „'Z GREAT BODILY HARM ~ ~~U (SDTEIAFDFE WNEFIAGHT) ~ PULLED AWAY q OTHER AWlETAAPCOKN W I7110U7 ~ WFJ~PON ~ Q ETHER OTHER FLED WITH NANOGIIN OTHER OTHER POINTED HANDGUN AT OFFICERS j~ MEMBER PRESENCE ~ OPEN HAND STRIKE ~ ELBOW STRIKE ~ KNEE STRIKE ~ F1REAfZM • a VERBAL COMMANDS ~ TAKEDOWN/EMERGENCY ~ ~y zW ESCORT FpLDS n pHA~N CDHCEUMFICFAI.NLG WEAPON ~ SCTLfO3S1EK0E1lP1UANNC0H ~ KICKS ~ ~ OTHER W WRISriOCK -t ~" ~ d ARMBAR ~ CANINE ~ IMPACT WEAPON jYd ,W~ ~N PRESSURE SENSITIVE AREAS n TASER (Probe Discherpe) q (~~Tiba In Boz 40) ~ (IDMePscArCiTbe M iUn NBoIxT 4p0NJ q V CdJTROL INSTRUMENT I~ TASER (Contecl Stun) ~ LJ V OGCHEMICAL N~FAPON TASER (Laser Terpo~ed) WIAUTHORIZATION TASER (Spark Displayatl) ~ OTHER OTHER OTHER 39. '~~ CHEMICAI,W EAPON AU7HORI2ED BY( NAME) 40, ADDITIONAL INFORMATION _~f OFFENDER'S HANDGUN RECOVERED. POSITION STAR N0. UNIT zF~' Q 41.WEAPON TYPE ~ 00. SEMI-AU(O PISTOL. 42. INCIDENT OCCURRED 43, 41GHTINGCONDITIONS [] 01 Dayllpht 44.WEATHER CONDITIONS z ~ 01 REVOLVER u 05 CHEMICAL WEAPON ~ Indoors ~ Outdoors a OP~'~~' q 03 Dawn q 04 Dusty CLEAR Q~ OB Gootl Ahl6clal ~ ~ 02 RIFLE [~ 08 TASER (Probe Distl~erpe) 45. MAKFJMANUPACTURER A8. MODEL 47,&4RREL LENGTH 4B, CALIBER/GAUGE ~ f]0 3 SHOTGINJ L 070THER GLOCK, ~Nc.-au- 36 ~ 3.78 4~J CiA~. Q = 49. TASER DPRT ID N0. 50. WEAPON SERIAL No,( Include Letters) 61. CHICAGO GUN REG. NO. 52. IL FIREARM OWNER ID: NO. 63. HPNDGUN CERTIFICATE Np. U N NKX233 R0114385 65010527 0 z 54. SPECIAL WEAPON CEf2TIFICATE NO. 55. PROPERN INVENTORY NO, 56. TYPE OF AMMUNITION USED 57.N0. OF WEAPONS DISCHARGED BY 58. TOTAL N0.OF SHOTS MEMBER 0 UNK Department Issued THIS MEMBER. 1 FIRED- 9 a W 59,Wh10 FIRED FIRST 6H0T ~03 OTHER (SPECIFY) 80• WAS FIREARM RELOADED 81. NOOF CATDRIOGESI 82. HOW WAS MEM8ER5 W4N000N WORN ~03 OTHER (Spedfy) ~ 3 PARTNER WRING INCIDENT SHOT 3HELL3 ~]0 1 MEMBER- ~]0 20FFENDER - ~ Ot YES[] p2 NO RELOAOEQ G Q9 Ot RT. SIDE (WAISn q 02 LT. SIDE (WAIST) ~ 63. HOW WAS MEMBER'S HANDGUN DRAWN []0 3 OTHER (Specify) ,S pF.CIFY MElNODJEOUiPMENTUSED TO RELQ4D MAGAZINE B5. DID MEMBER USE SIGHI'3 '~ 07 STRONG SIDE DRAW []0 2 CROSS DRAW ~ o, r~s [I o2 rro ~ °Z e6. DESCRIBE PROTECTIVE COVER USED( LIGHT POLES, DOORWAYS, CAR, FLIRNITUliE, ETC) 6Y. DISTANCE BETWEEN INVOLVED MEMBER 8 OFFENDER WHEN FIRST SHOT WAS flRED NONE q 010-OS FT. [] 0205•i~FT. ~ 0310.15FT. [] OA OVER I5FT. ~1 cD 6B. PERSON/08JECT STRUgC AS RESULT OF THE DISCHARGE OF MEMBERS WEAPON 88. POSITION OF MEMBER DISCHARGING WEAPON ~ p~ STANDING [~ 02 LYING DOWN UI 01 PER30N Q 02 OBJECT [] 03 BOTH q 04 UNKNOWN ~ 03 SITTING q 00. KNEELING q 050THER( SPEEIFY) ~Z' NOTIFICATIONS( OC OR TASER INCIDENT): q OEMC LS DESK SGT.& W.C./DIST. OF OCCUR. j O NOTIFICATIONS LF IREARM INCIDENT)~ ~ OEMC ~$ DESK SGT.& W.C./DIST, OF OCCUR. 6d OP COMMAND ~ DET. DIV. ~o Members will ensure that all required notifications and all witnesses to this use of force are documented in the appropiate case report. ~ 73. REPORTING MEMBER (Print Name) STPFIEMP~OYEE NO. SIGNATURE ~ ~ W N ALL, MOHAMMED 7241 NA ~ 01-JUN-201104:53:52 -~ N Q Reviewing supervisor will ensure the legibility and completeness of this report and attest by entering the required information below. 'V z (~ 74, REVIEWING SUPERVISOR (Print Nerve) STAR NO. SI('iNATURE DATE REVIEWED TIME u> JONES,J AMES E 73 p1-JUN-2011, 04:55:26 ~D-11.377( REV. 10/07) /D~ L 'X~j~~ ~ ~`,,,~ ~~ `' 4J(/ ~ ~: ~~.~~ WATCH COMMANDER/OCIC REVIEW 7HE WATCH COMAMNDER WILL COMPLETE THE REVIEW SEC710N FOR i.) ALL INCIDENTS 7FiAT DID NOT INVOLVE THE DISCHARGE OF A FIREARM; 2.) FIREARM DISCHAfiGE INCIDENTS INVOLVING THE DESTRUCTION OF AN ANIMAL OR; 3,) ACCIDENTAL DISCHARGE OF A FIREARM NOT RESULTING IN AN INJURY 70 ANY PERSON. THE ADS WIU. COMPLETE THE REVIEW SECTION FIX3 ALL INCIDENTS INVOLVING; 1,) THE DISCHARGE OF A FIREARM OR IMPACT MUNITIONS BY OR AT A DEPARTMENT MEMBER EXCEPT FORAN ANIMAL pESTRUCTiON OR AN ACCIDENTAL pISCHARGE THAT DOES NOT RESULT IN AN IWURY TO ANY PERSON; 2.) MEM9ER'S USE OF FORCE BY WHATEVER MEANS THAT RESULTS IN THE DEATH OF A PERSON', 3.) ANY LESSER USE OF FORCE 6Y A DEPANTMENT MEMBER WHEN THAT USE OF FORCE STEMS FROM THE SAME INCIDENT DESCRIBED NERE IN 1 OR 2. 75. SUBJECT'S 3TATEMENT REGARDING THE USE OF FORCE pNq .~ REFUSED UNABLE 70 INTERVIEW (Speclry Reason) The subject is deceased. 76. WATCH COMMANDER/OCIC RATIONALE FOR BOX 77 FINDING !t is the preliminary determination of the undersigned that Police O~cer Mohammed Ali #7241 acted in compliance with Department policy in that the offender pointed a handgun in the direction of Officer Ali. In fear of his Life and his partners li(e O~cer All discharged his weapon. CL# 1045804 U# 11-27 Y7. WATCH COMMMlDER/OCIC FINDING BASED UPON CURRENTLY AVAILABLE INFORMATION: HAVE CONCLUDED THAT THE MEMBER'S ACTIONS [J I HAVE CONCLUDED THAT FURTHER INVESTIGP,TION IS REQUIRED. VYERE IN COMPLIANCE WITH DEPARTMENT PROCEWRES AND DIRECTIVES, roc rvo.roRNo. 1045804 OBTAINED 78. WATCH COl.MMNDER/OCIC (Print Neme) SIGNATURE DATE COMPLETED TIME WELCH III, EDDIE L 01JUN-2011 05:00:44 79. DISTRIBUTION OF ORIGINAL TRR; p TRR PApCET, INCLUDING THE TRR AND COPIES OF THE BELOW LISTED ~+T7'ACHMENTS WILL BE FORWARDED TO THE OFFICE OF PROFESSIONAL STANDARDS. ATTACHMENTS -PHOTOCOPIES OF: ~ SUPPLEMENTARY REPORT q I.O.D, REPORT 8p, TOTAL TRR's THIS EVENT No. Q CASE REPORT Q~ OFFICER BATTERY REPORT [] CR INITIATION REPORT 3 ARREST REPORT q TO-FROM-SU&lEC7 REPd7T5 FROM DEPPRTMENT WITNESSES)