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Forestal OWI PC
1. CASE NUMBER: 49609-1 908-F6-o32060 FILED: 8/14/201 9
State Form 44213 (R6 / 10-10)
INITIAL HEARING COURT (IHC) - CRIMINAL
STATE 0F INDIANA IN THE DIVISION COURT COUNTY OF MARION SS
State 0f Indiana )
VS_ )
COURT CAUSE NUMBER AGENCY CASE NUMBER IP190087956
FORESTAL, DANlEI- P- AFFIDAVIT FOR PROBABLE CAUSE
I, M. HARRIS a law enforcement officer with the (agency) INDIANAPOLIS METROPOLITAN POLICE ,
affirms that on
(date) 08/10/2019 ,
at approximately 11:44 Dam .pm the accused, (first name) DANIEL
(middle initial) P (last name) FORESTAL ,
a .Male DFemale, (d/o/b) 03/03/1983
(DL number or last four digits of SSN) 0620343533 (license type) OPERATOR ,
was observed in (location) 6990 E 215T ST
(county) MARION ,
Indiana operating a (vehicle description, include CMVand
Hazmat indicator): 2007 MERCURY RED IN / us 453FAA under the following circumstances.
I
I. PRELIMINARY OBSERVATION/REASON FOR STOP (check all that apply) I
D Iobserved the accused operate a vehicle in my presence and View.
OFFICER GREG SHUE observed the accused operate a vehicle.
Ihad reason to believe the accused operated the vehicle because: ACCUSED ADMITTED T0 OPERATING
The accused committed the following Violation(s): 35—44.1—2-6(a)
D Passenger under age 18 pursuant to IC 9-30-5-3(2)
D Other:
Crash Involved:
D Yes No Crash involved Local Crash Number: Time of Crash: Dam meD The accused admitted to being the driver involved in the crash.
D The result 0f the accused driving resulted in: D serious bodily injury D fatality
Name(s) of person(s) injured:
|
II. OBSERVATIONS
I had reason to believe the accused was INTOXICATED because I observed the following: Field Test Passed Failed
Z Odor of alcoholic beverage D Left vehicle in gear D HGN D D
: Alcohol beverage containers in View D Failed t0 shut off vehicle D Walk and Turn D D
: Speech was D Could not open door D One Leg Stand D D
Z Eyes were RED/GLOSSY D Pulled self from vehicle D Rhomberg Balance D
: Manual dexterity D Staggered from vehicle D P.B.T./Alco-sensor o. gram of alchohol per 210 liters of breath
: Abusive attitude D Leaned against vehicle
Z Balance was UNSTEADY DRE: Conclusion: Performed by:
: Soiled/disorderly clothing
: Other observations/test:
|
III. CHEMICAL TEST |
Z [advised the accused of the Implied Consent Law and the accused: D submitted to, or refilsed a chemical test results are pending—
Iwas unable to offer a chemical test to the accused because such person was: D unconscious D injured
_ ,
a certified chemical test operator, determined from a chemical test that the accused had an alcohol concentration equivalent to
o. gram of alchohol per 210 liters of breath. The chemical test was administered at (location) at
Dam me using certified instrument number .
Iwas told by the result of the chemical test was an alcohol concentration equivalent to 0. gram of alcohol per 100
milliliters of blood. Such test was administered by drawing or taking a sample of whole blood at 1:17 am me. Drawn by: B. FULLBRIGHT RN
I was told by (name) the result of the chemical test determined that the accused had in his/her body a controlled substance, a
controlled substance metabolite, or a drug, to wit . Such test was administered by drawing or taking a sample of: blood, D urine,
other at (location) ESKENAZI at (time) 1:17 .am me.
Drawn by: B. FULLBRIGHT RN
WITNESS INFORMATION (Only Print Witness Information on Officer and Prosecutor Copy.) I
Name Address TX Number
Name Address TX Number
PREVIOUS INDIANA AND OUT OF STATE CONVICTION(S) I
Offense, Court Information, Conviction Date and Court Cause/Case number.
Offense, Court Information, Conviction Date and Court Cause/Case number.
THE ACCUSED COMMITTED A VIOLATION OF IC 9-30-5, IC 14-15-8, OR IC 31-37-19.
I AFFIRM PURSUANT TO IC 35-34-1-2.4 UNDER THE PENALTY 0F PERJURY THAT THE FOREGOING FACTS ARE TRUE.
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D
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Signature 0f Affiant Date (month, day, year) Print name and department
Isl M. HARRIS 08/1 1/2019 M. HARRIS / INDIANAPOLIS METROPOLITAN POLICE
ORIGINAL T0 PROSECUTOR/COURT lst COPY T0 BMV FROM COURT 2nd COPY FOR OFFICER
BUREAU 0F MOTOR VEHICLES CERTIFICATE
Court Cause/Case Number: Agency Case Number: IP190087956
Offense Date (month, day, year): 08/10/2019 Time: 11:44 Dam .pm (DL number or last four digits of SSN) 0620343533
Driver License Type: OPERATOR Driver License State: INDIANA
Full Name: (First) DANIEL (Middle Initial) P (last) FORESTAL
Date of Birth: 03/03/1983 Gender: MALE Weight: 200 Height: 6' 0" Eye Color: BLUE Hair Color: BROWN Race: WHITE
Address (number and street, city, state, and ZIP code): 1101 N LAYMAN AVE INDIANAPOLIS, IN 46219
Vehicle Type: Passenger D CMV D Hazmat D Other:
The above Motorist: Refused D Failed Alcohol Test 0. _BAC Drugs: D Yes D No Pending Results ofAlcohol or Drug Test(s)
PROBABLE CAUSE FOUND THAT DEFENDANT VIOLATED IC 9-30-5 OR IC 14-15-8 and charges are pending. THE COURT RECOMMENDS
THAT THE BMV TAKE THE FOLLOWING ACTION 0N DEFENDANT'S DRIVING PRIVILEGES:
DImmediate Suspension DSuspend upon notice from the Bureau of Motor Vehicles DCourt Ordered Ignition Interlock Device in Lieu of Suspension
Judge's Signature: Date (month, day, year): I /
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