GEORGIA BOARD OF PRIVATE DETECTIVE AND SECURITY AGENCIES 237 COLISEUR DRIVE MOON, GA. 31217 NI Please Nata: inhma?on must be provided. Licensa Number: 9011mm: exact inducing city where mapnn was discharged: Give 3 Please attach inn-house with warms the noti?ed? include and case number of incident Page 2 anion was taken: ofmostrecer? Firearm 4. Fimann instructor?s I I {hat the abave infarma?m if wheat. I deciliter 25a: ?Is?v? ??w?hi?d the weapons dimharge in cidem to the best of my: knowledge. Date of Company Incidmt Report may Wm Statements Police Rm (if nomad) New Hangs Scams ?aming mutation - NOYARY WC Do No! We in this Section: Beam mm Use mi.- Pmsanted to Action Taken: