RIDE ALONG REQUEST DAKI DUK

[Daki duk]

RIDE ALONG REQUEST

1. PERSONAL INFORMATION

• 1.1 FULL NAME

• • FIRST NAME:[Daki]
    MIDDLE NAME:
    LAST NAME:[Duk]

2. DATE OF BIRTH

• • DOB(DD/MM/YYYY):[15 02 2002]
    Nationality:[Indonesia]
    Gender:[Male]

By signing this document, I acknowledge that the opportunity to participate in the Los Santos
Police Department Ride-Along Program is a privilege and that the assigned officer, Chief of
Police, or his designee can discontinue my participation in the ride-along program at any
time.

Sincerely yours,
your signature
[Daki duk]