Form 1-704 Supplementary Homicide Report (SHR)

Supplementary Homicide Report

Supplementary Homicide Report.xls

Supplementary Homicide Report

OMB: 1110-0002

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SUPPLEMENTARY HOMICIDE REPORT
1-704 (Rev. 5-22-07)














OMB No. 1110-0002

This report is authorized by law Title 28, Section 534, U.S. Code. Your cooperation in using this form to list data pertaining to all homicides reported on your



















Expires 9-30-10

Return A will assist the FBI in compiling comprehensive, accurate data regarding this important classification on a timely basis. Any questions regarding this report may be






















addressed to the FBI, Criminal Justice Information Services Division, Attention: Uniform Crime Reports/Module E-3, 1000 Custer Hollow Road, Clarksburg, West Virginia 26306;






















telephone 304-625-4830, facsimile 304-625-3566. Under the Paperwork Reduction Act, you are not required to complete this form unless it contains a valid OMB control number.





















The form takes approximately 9 minutes to complete.














































1a. Murder and Nonnegligent Manslaughter






















List below for each category specific information for each murder and nonnegligent homicide and/or justifiable homicide shown in item 1a of the monthly Return A. In





















addition, for justifiable homicide list all justifiable killings of felons by a citizen or by a peace officer in the line of duty. A brief explanation in the circumstances column regarding






















unfounded homicide offenses will aid the national Uniform Crime Reporting Program in editing the reports.














































Incident Situation* Victim** Offender** Data Code Weapon Used
(Handgun, Rifle, Shotgun,
Club, Poison, etc.)
Relationship of Victim
to Offender
(Husband, Wife, Son,
Father, Acquaintance,
Neighbor, Stranger, etc.)
Circumstances
(Victim shot by robber, robbery victim
shot robber, killed by patron during
barroom brawl, etc.)

Age Sex Race Ethnicity Age Sex Race Ethnicity Do Not Write
In These Spaces











































































































































































*






















** - See reverse side for explanation











































DO NOT WRITE HERE





















Recorded






















Edited

Month and Year
Agency Identifier
Prepared By
Title
Entered






















Verified






















Adjusted

























Agency
State
Sheriff, Chief, Superintendent, Commanding Officer

























FBI/DOJ
























SUPPLEMENTARY HOMICIDE REPORT (Continued)
















































1b. Manslaughter by Negligence






















Do not list traffic fatalities, accidental deaths, or death due to the negligence of the victim. List below all other negligent manslaughters, regardless of prosecutive action taken.













































Incident Situation* Victim** Offender** Data Code Weapon Used
(Handgun, Rifle, Shotgun,
Knife, etc.)
Relationship of Victim
to Offender
(Husband, Wife, Son,
Father, Acquaintance,
Neighbor, Stranger, etc.)
Circumstances
(Victim shot in hunting accident, gun-
cleaning, children playing with gun, etc.)

Age Sex Race Ethnicity Age Sex Race Ethnicity Do Not Write
In These Spaces











































































































































































* - Situations


A - Single Victim/Single Offender










D - Multiple Victims/Single Offender









B - Single Victim/Unknown Offender or Offenders










E - Multiple Victims/Multiple Offenders









C - Single Victim/Multiple Offenders










F - Multiple Victims/Unknown Offender or Offenders





Use only one victim/offender situation code per set of information. The utilization of a new code will signify the beginning of a new murder situation.






















** - Age

- 01 to 99. If 100 or older use 99. New born up to one week old use NB. If over one week, but less than one year old use BB. Use two characters only in age column.



















Sex
- M for Male and F for Female. Use one character only.



















Race
- White - W, Black - B, American Indian or Alaskan Native - I, Asian or Pacific Islander - A, Unknown - U. Use only these as race designations.



















Ethnicity -

Hispanic Origin - H, Not of Hispanic Origin - N, Unknown - U.


















File Typeapplication/vnd.ms-excel
Authorpsfaulkner
Last Modified Bypsfaulkner
File Modified2007-05-21
File Created2006-02-01

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