[RIDE ALONG LSSD REQUEST] MAD DUNGIE

[shenzha]

RIDE ALONG REQUEST

1. PERSONAL INFORMATION

• 1.1 FULL NAME

• • FIRST NAME: MAD
    MIDDLE NAME:
    LAST NAME: DUNGIE

2. DATE OF BIRTH

• • DOB (DD/MM/YYYY): 03/08/1996
    Nationality: INDONESIA
    Gender: MAN

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

Sincerely yours,
your signature
[MAD DUNGIE]

[Ken Petterson]

ACCEPTED

Dear Mr. Dungie,

We are pleased to inform you that your application to participate in the Los Santos Police Department Ride-Along Program has been reviewed and approved.

Your scheduled ride-along will take place on 04/10/2025 at Roxwood Station. Please arrive at the front desk of the Roxwood Station, located at Roxwood.

Sincerely,

Ken Petterson
Los Santos Sheriff Department