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Home My Public Portal AboutPRR 22-2884 TOWN OF GULF STREAM PALM BEACH COUNTY, FLORIDA Delivered via e-mail May 24, 2022 Peter MacDonald [mail to: pmac126@msn.com] Re: GS #2884 (Police Report) Would like a copy of the police report #22-0061. Dear Peter MacDonald [mail to: pmac126@msn.com]: The Town of Gulf Stream has received your verbal public records request on May 23, 2022. You should able to view your request and response at the following link : https://portal.laserfiche.com/Portal/DocView.aspx?id=179059&repo=r-430100cc We consider this request closed. Sincerely, Reneé Rowan Basel As requested by Rita Taylor Town Clerk, Custodian of the Records CS(�� LZ- J- S Fraudulent Item Affidavit SECURITY DEPARTMENT . YOU MAKE THIS CLAIM e aware that a false declaration could subject you to a criminal prosecution for perjury. Filing this Declaration means that UMB Bank wide any of this information to law enforcement agencies that will assist in the recovery of funds and prosecution of individuals A. This Affidavit must be returned to UMB no later than two weeks from the date that this affidavit was received by claimant, or this ,s ha valid_ 1E OF CLAIMANT (PERSON ATTESTING TO FRAUD) DAYTIME PHONE NUMBER Peter S Macdonald _ ( 917 ) 364-6971 .CCOUNT TITLE ACCOUNT NUMBER Individual XXXXX8136 STREET ADDRESS CITY STATE ZIP 3500 N Ocean Blvd Gulf Stream FL 33483 ® CHECK NUMBER 1 029 I DATE OF ITEM DATE PAID AMOUNT ❑ SAVINGS WITHDRAWAL 12/15/2021 12/20/2021 s2268.00 MAKER (NAME ON CHECK) MAKER SIGNATURE NAME Peter Macdonald Peter Macdonald PAYABLE TO ENDORSED BY Bryson Roofing Inc illegible DECLARATION My purported signature/endorsement appears on the item described above. I have carefully examined it and hereby state that the item rlaccrihad ahnva k nr cnntains a' ❑ FORGED MAKER SIGNATURE OR UNAUTHORIZED SIGNATURE ❑COUNTERFEIT CHECK ❑ UNAUTHORIZED DRAFT ❑ FRAUDULENT IMAGE REPLACEMENT DOCUMENT ® FORGED OR IMPROPER ENDORSEMENT: CLAIMANT IS ® MAKER OR ❑ PAYEE ❑ ALTERED PAYEE FROM TO ❑ ALTERED NUMERIC AMT FROM To ❑ ALTERED WRITTEN AMT FROM TO I ALSO DECLARE THAT: I DID NOT RECEIVE ANY BENEFIT OR VALUE FROM THE PROCEEDS OF THE CHECK, WITHDRAWAL, OR DEPOSITED ITEM NOR WERE ANY PROCEEDS APPLIED TO ANY USE OR PURPOSE ON MY BEHALF, AND I HAVE NOT ARRANGED WITH THE PERSON(S) WHO PERPETRATED THE FORGERY/COUNTERFEIT/ALTERATION TO BE REIMBURSED FOR ANY PROCEEDS OF THE CHECK, WITHDRAWAL, OR DEPOSITED ITEM, AND I PROMISE TO TESTIFY OR CERTIFY TO THE TRUTH OF APPLICABLE STATEMENTS IN THIS DECLARATION BEFORE ANY OFFICIAL, JUDGE, OFFICER OF THE COURT, OR OTHER PERSON, IN ANY CASE NOW PENDING OR WHICH MAY OCCUR REGARDING THIS DECLARATION. I BELIEVE THE FORGERY OF MY NAME WAS MADE BY WHO RESIDES AT I AM PROTECTED BY FORGERY INSURANCE AS FOLLOWS: I AM MAKING THIS STATEMENT VOLUNTARILY. I AGREE THAT THE BANK IS AUTHORIZED TO DEBIT MY ACCOUNT(S) SHOULD THE BANK'S INVESTIGATION CONCLUDE THAT I AUTHORIZED ANY ITEM. I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THIS STATE THAT THE FOREGOING IS TRUE AND CORRECT. CLAIMANT SIGNATURE 'IF COMMERCIAL ENTITY, CLAIMANT'S TITLE DATE ORIGINATED BY PHONE NUMBER DATE PREPARED Tony Ullrich ( 859 ) 386-3231 2/5/2022 State of County of (Seal) (ss) Subscribed and sworn to before me this day of Notary Public UMB i5590003 (R 03/05) AGENCY NAME +INCIDENT NUMBER GULF STREAM POLICE DEPARTMENT - v UNIFORM INCIDENT REPORT CLEARANCES CALL NUMBER 'GEOCODE 220061 TOD A ❑ Death of Suspect G ❑ Arrest - Juvenile 1019 ❑ INCIDENT (NON -CRIMINAL) B ❑ Prosecution Declined H ❑ Warrant Issued UJ Z TOA M OFFENSE Gulf Stream Police Department C ❑ In Custody of Other Jurisd. 1 ❑ Invest. Pending F- 1019 ❑ SUPPLEMENT 246 Sea Road D ❑ Victim Refused to Coop. J ❑ Closed x TOC E ❑ Juvenile/No Custody K ❑ Unfounded � 1120 Gulf Stream, FL 33483 F ❑ Arrest - Adult U ❑ Unknown z Phone: (561) 278-8611 Fax: (561) 276-2528 `CLEARANCE CLEARED p DATE BY Q 'REPORT DATE[TIME 'INGOENT OCCURRED FROM 'INCIDENT OCCURRED TO MONTH DAY YEAR TIME MONTH DAY YEAR TIME MONTH DAY YEAR TIME 01 101 -11 ((10 eetpppp Itt2yy022 pp)) IN350onN. OCEANOBLVD. GULF STR�AMer L33483 FF SE 'OFFENSE CODE A/C FIM & DEGREE 'HATE/BIAS `LARGE 'TYPE CRIMINAL ACTIVITY 1. FRAUD -ALL OTHER 1 (Enter up to three for each offense) 1. 2. 3. B- BUYINGIRECEIVING _ _ C- CULTIVATINGIMFG./PUB. 2- 2. D- DISTRIBUTING/SELLING 1. - 2. - 3- - E- EXPLOITING CHILDREN 3. 3. 0- OPERJPROPOTING/ASSIST. 1. 2. 3. P- POSSESSING/CONCEALING - T- TRANSPrTRANSMrrTING 4. 4. U- USING/CONSUMING 1. 2._ 3. G- OTHER GANG ACTIVITY J- JUVENILE GANG ACTIVITY 5. 5. 1 2 3 N- NO GANG ACTIVITY LOCATION OF OFFENSE (Enter up to two) 12 JaillPrison 59 Daycare Facility 40 Other Retail Store OTHER 'SUSPECTED OF USING 1. 2. 13 Parking Garage 41 Fartory/Mill/Plant 53Abandoned] RESIDENTIAL STRUCTURE 14 Other Public Access Buildings RETAIL 42 Other Building Condemned Structure A ❑ ALCOHOL 01 Single Family Home 26 Bar 55 Arena/Stadium! 27 Bu ! 02 Multiple Dwelling COMMERCIAL LOCATIONS y SeillTrade Shop OUTSIDE Fairgrounds/Coliseum W U) 03 Residential Facility 15 Auto Shop 28 Restaurant 43 Yard 58 Cargo Container 03 D DRUGS Z 16 Financial Institution 29 Gas Station 44 Construction Site 60 DocktWharf/Frei ht/ 04 Other Residential g W LL 17 Barber/BeautyShop 05 Garage/Shed P 30 Auto Sales Lot 45 LakeANaterway Modal Terminal C ❑ COMPUTER EQUIPMENT LL 18 Hotel/Motel 31 Jewelry Store 46 FieldlWoods 61 Farm Facility O PUBLIC ACCESS BLOGS. 19 Dry Cleaners/Laundry 32 Clothing Store 47 Street 62 Gambling Facility/ ❑ 06 Transit Facility 20 Professional Office 33 Drugstore 48 Parking Lot Casino/Race Track N NOT APPLICABLE 07 Government Office 21 Doctor's Office 34 Liquor Store 49 Park/Playground 63 Military Installation TYPE WEAPON/FORCE USED 08 School 22 Other Business Office 35 Shopping Mall 50 Cemetery 65 Shelter -Mission/ 09 College 23 Recreation/Entertainment Center 36 Sporting Goods 51 Public Transit Vehicle Homeless 67 Libra 54 Amusement Park 37 Grocery/Supermarket 52 Other Outside Location 66 Tribal Lands Library a Facility 10 Church 24 Rental Storage y 38 Variety/Convenience 57 Camp/Campground 77 Other 11 Hospital 25 Other Commercial Service Loc. 39 Department Store 64 Rest Area 1. 2. 3. 56 ATM Machine Separate from Bank *METHOD OF ENTRY 'METHOD OF ENTRY - MOTOR VEHICLE THEFT 'METHOD OF ENTRY- BURGLARY/B&E ENTRY EXIT ENTRY EXIT 1 ❑ FORCE 01 ❑ Motor Running/Keys in Car 06 ❑ Hot Wire ENTRY EXIT 1 ❑ DOOR ❑ 1 ❑ FRONT ❑ 2 ❑ NO FORCE 02 ❑ Unlocked 07 ❑ Slim Jim/Goat Hanger 1 ❑ BASEMENT❑ 2 ❑ WINDOW ❑ 2 ❑ SIDE ❑ 'NO_ PREMISES ENTERED 03 ❑ Duplicate Key Used 08 ❑ Tumblers Removed 20 1' FLOOR ❑ 3 ❑ GARAGE ❑ 3 ❑ REAR ❑ 04 ❑ Window Broken 09 ❑ Column Peeled 3 ❑ 2No FLOOR ❑ 4 C1 SKYLIGHT ❑ 4 ❑ ROOF ❑ 05 ❑ Towed 10 ❑ Ignition Peeled 4 ❑ OTHER ❑ 5 ❑ OTHER ❑ 5 ❑ OTHER ❑ METHODS OF `CARGO THE OPERATION Y❑ N❑ 'NO.. `TOTAL 'VICTIM I LJ INDIVIDUAL F LI FINANCIAL INSTITUTION P Ll POLICE OFFICER (IN THE LINE OF DUTY) S I I SOCIETY 0 U OTHER VICTIMS TYPE ❑ BUSINESS G❑ GOVERNMENT R❑ RELIGIOUS ORGANIZATION U []UNKNOWN B NAME (Last, First, Middle) MACDONALD, PETER ADDRESS (Street, Apt, City, State, Zip) PHONE 3500 N. OCEAN BLVD GULF STREAM FL 33483 646-792-2080 EMPLOYER NAME AND PHONE ADDRESS (Street, Apt, City, State, Zip) AGE/ EX CE U B U A HNICITY HGT WGT HAIR EYES D.O.B. ❑ W ❑ 1 ❑ U U OCCUPATION SN-RESIDENT 1 RESIDENT 3 U MILITARY 5 OTHER j STATUS 2 ❑ TOURIST 4 ❑ STUDENT U ❑ UNKNOWN 'VICTIM U Y IF INJURED, DESCRIBE c z INJURED? ❑ N INJURIES: g 2 AGG. ASSAULT/ 'LEOKA INFORMATION ICTIM/SUSPECT RELATIONSHIP VICTIM/OFFENSE LINK A z HOMICIDE CIRC. TYPE OF ACT. ASSIGN. TYPE OR] -OTHER I 0. 1- 2. 3. 4. 5. REPORTING OFFICER BADGE NO DATE OFC. JUSTIN MENARD 0111012022 APPROVING OFFICER BADGE NO. DATE CAPT. JOHN HASELEY 01/12/2022 FOLLOW-UP? lt yes, follow-up ❑ Y ❑ N ignment: ADDITIONAL LJ VICTIMIWITNESS LJ PROPERTY U STATEMENTS FORM RECEIVED BY: U INTELLIGENCE SPECIAL SUPPLEMENTS ❑ SUSPECT/ARRESTEE ❑ NARRATIVE ❑ OTHER ❑ INVESTIGATION ❑ RECORDS COPIES arzoi+ INCIDENT REPORT - PART 2 (INCIDENT NUMBER 220061 TIME N0. NAME MMA AILMETER AGE! SSN 1 D.O.B. W ADDRESS eetq�t N GULF S1P�EAM PHONE .(OC BVD FL 33483 M6-792-2080 O EMPLOYER NAME AND PHONE W ADDRESS (Street, Apt, City, Stale, Zip) STATEMENTS OBTAINED UY U N TYPE: U WRITTEN U ORAL U TAPED U OTHER CHECK CATEGORIES U STOLEN LJ RECOVERED U IMPOUNDED U RECEIVED U SUSPECTS VEHICLE U VICTIMS VEHICLE U UNAUTHORIZED USE UABANDONED NO. U DAMAGE TO VEHICLE LIC LIS LIY LIT VIWOAN 'VALUE ❑ THEFT FROM VEHICLE VYR VMA VMO VST VCO VEHICLE UY KEYS INU Y HOLD U Y RELEASE U Y OP OTTOU LOCKED ❑ N VEHICLE ❑ N VEHICLE ❑ N CONTENTS❑ N LU VEHICLE ASSOC. VEHICLE ASSOC. VEHICLE Y TOWED OWNERSHIP U TAG RECEIPT TITLE C.) / SUSPECT NO. / VICTIM NO. TOWED? ❑ N By VERIFIED BY: ❑ BILL OF SALE ❑ OTHER S STOLEN MOTOR NO. STOLEN AREA STOLEN RESID. ADDITIONAL UJ VEHICLE ONLY ❑ BUSINESS ❑ RURAL I I DESCRIPTION AUTO INSURER NAME (Company) ADDRESS (Street. Apt., City, State, Zip) PHONE MOTOR VEHICLE N0, RECOVERED DATE REG. STOLEN IN YOUR JURISDICTION RECOVERY ONLY I ❑ Y ❑ N WHERE RECOVERED? 'TYPE PROPERTY 1 NONE 3 COUNTERFEITEDIFORGED 5 STOLEN/ETC. 7 RECOVERED P PHOTO TOTAL VALUE LOSSIETC. (eMwwde below) 2 BURNED 4 DESTROYED/DAMAGED/VANDALIZED 6 SEIZED U UNKNOWN E EVIDENCE OSS DESCRIPTION •PROP 'VALUE ODE r CODE VICT. VEH MAKE/BRANDQUANTITY MAKE/BRAND MODEL DATE RECOVERED N0. NO. SERIAL NCIC OTHER NUMBER NUMBER NUMBER -LOSS QUANTITY DESCRIPTION 'PROP 'VALUE CODE CODE I VICT. IVEH MAKEBRAND MODEL DATE RECOVERED N0. I N0. ERIAL NCIC OTHER UMBER NUMBER NUMBER UANTITY DESCRIPTION 'PROP 'VALUE CODE H MAKE/BRAND MODEL DATE RECOVERED OWERIALNCIC JNUMBER OTHER O.UMBER NUMBER NUMBER wUANTITY DESCRIPTION •PROP 'VALUE a CODE EH MAKEBRAND MODEL DATE RECOVERED O. ERIAL NCIC OTHER UMBER NUMBER NUMBER CODES: 10 Other Valuables 22 Photographic Equipment 72 Musical instruments VEHICLES STRUCTURES EXCHANGE MEDIUMS PERSONAL EFFECTS 23 Farm Equipment 73 Portable Electronic Equip. 35 Aircraft 46 Single Occupancy 01 Money 11 Clothing/Furs 24 Heavy Constructionfindustrial 74 Watercraft Equip./Parts/Acc. 36 Automobiles 47 Other Dwellings 02 Credit/Debit Card 12 Purses/Handbags/Wallets 25 Building Supplies-Const. 29 Other Equipment 37 Bicycles 48 CommerciaMusiness 03 Negotiable Instruments 13 Other Personal Effects 26 Tools CONSUMABLE ITEMS 38 Buses 49 IndustriatfManufacturing 04 Other Exchange Mediums HOUSEHOLD ITEMS 27 Vehicle PartslAccessories 30 Alcohol 39 Trucks 50 PublidCommunity DOCUMENTS 14 Household hems 57 Aircraft Parts/Accessories 31 Drugs/Narcotics 40 Trailers 51 Storage 05 Non -Negotiable Instruments EQUIPMENT 28 School Supplies 32 Consumable Goods 41 Watercraft 52 Other Structure 06 Personal (Identity) Papers 15 Drug/Narcotic Equip. 58 Artistic Supplies/Accessories 60 Chemicals 42 Recreational Vehicle OTHER 62 Documents/Personal or 16 Gambling Equipment 59 Camping/Hunting/Fishing 61 Crops 43 Other Motor Vehicle 53 Merchandise Business 17 Computer Hardware/Soft. Equipment/Supplies 63 Explosives WEAPONS 54 Other Property 07 Other Documents 18 Office Equipment 67 Law Enforcement Equip. 65 Fuel 44 Firearms 55 Pending Inventory VALUABLES 19 Stereo TV Equip. 68 LawnfYard/Garden Equip. ANIMALS 45 Other Weapons 66 Identity -Intangible 08 Jewelry/Precious Metals 20 Recordirgs-Audio Visual 69 Logging Equipment 33 Livestock 64 Firearm Accessories 71 Metals, Non -Precious 09 Art Objects, Antiques 21 Sports Equipment 70 Medical/Medical Lab Equip. 34 Household Pets ON JANUARY 10, 2022 AT APPROXIMATELY 1019 HOURS I MADE CONTACT WITH MR. PETER MACDONALD VIA CELL PHONE 2. MR. MACDONALD'S ADDRESS IS 3500 NORTH OCEAN BOULEVARD. MR. MACDONALD WAS A VICTIM OF CHECK FRAUD. MR. MACDONALD HAD NOTICED THE CHECK FRAUD ON JANUARY 5, 2022. MR. MACDONALD'S CHECKS ARE LINKED TO HIS FIDELITY ACCOUNT. FIDELITY USES UMB BANK FOR ITS CUSTOMERS. MR. MACDONALD HAD SENT BOTH CHECKS USING US MAIL FROM HIS 3500 NORTH j OCEAN BOULEVARD MAIL BOX. BOTH CHECKS WERE DROPPED IN HIS 3500 NORTH OCEAN BOULEVARD MAIL BOX ON TWO ~ DIFFERENT DATES. THE FIRST DATE WAS APPROXIMATELY DECEMBER 7, 2021 AND THE SECOND DATE WAS APPROXIMATELY DECEMBER 15, 2021. MR. MACDONALD HAS INFORMED FIDELITY. IN TURN, FIDELITY WILL NOTIFY UMB. I TOLD HIM TO CONTACT a z THE UNITED STATES POSTAL SERVICE/FRAUD DEPARTMENT. MR. MACDONALD THINKS THE BANK IS CLOSING HIS ACCOUNT. MR. MACDONALD WILL PROVIDE THE GULF STREAM POLICE DEPARTMENT COPIES OF THE TWO FRAUDULENT UMB CHECKS FOR THE &cell CASE FILE. NO OTHER ACTION TAKEN. END OF THE REPORT. RREINCID SUSPECTIARREST SUPPLEMENT 220061 GENCYNG NUMBER VICTIM FFENSE NCIDENT DATE D TIME NO. ADULT JUVENILE UNKNOWN APPROPRIATE CATEGORY CHARGES FILED? 1 ❑ ❑ gj rHECK ]SUSPECT ❑ ARRESTEE ❑SUSPECT/ARRESTEE []RUNAWAY ❑ MISSING ❑ OTHER ❑Y N NAME (Last, Felt, Middle) SSN UNKNOWN, ALIAS GANG AFFILIATION ADDRESS (Street, Apt, City, State, Zip) PHONE UNKNOWN EMPLOYER NAME AND PHONE ADDRESS (Street, ApL, City, State, Zip) LACE OF BIRTH DL#/STATE OCCUPATION/SCHOOL W 'AGE/ SEX rRACE u B U A ETHNICDI 'HEIGHT 'WEIGHT 'HAIR 'EYES d D.O.B. ❑ W ❑ I ❑ U I OC MARITAL SCARS, MARKS, TATOOS N STATUS W ADDITIONAL DESCRIPTTVES C a Z SUSPECTED OF USING POTENTIAL INJURIES? ❑ALCOHOL ❑DRUGS 'RESIDENT STATUS 1 ❑ RESIDENT 2 ❑ TOURIST 3 ❑ MILITARY 4 ❑ STUDENT 5 ❑ OTHER(explain) U ❑ UNKNOWN ARRESTEE WAS ARMED WITH ARRESTEE ARMED WITH 1. _ 2. _ 3. 99 NONE 13B OTHER FULLY AUTOMATIC FIREARM 16 IMITATION FIREARM 50 POISON 11 FIREARM 14 SHOTGUN 17 SIMULATED FIREARM 60 EXPLOSIVES 12 HANDGUN 15 OTHER FIREARM 18 BB/PELLET GUN 65 FIREANCENDIARY DEVICE 12A AUTOMATIC HANDGUN 15A SEMI -AUTOMATIC SPORTING RIFLE 20 KNIFEICUTTING INSTRUMENT 70 DRUGS/NARC/SLEEPING PILLS 13 RIFLE 15B SEMI -AUTOMATIC ASSAULT FIREARM 30 BLUNT OBJECT 00 OTHER WEAPON 13A FULLY AUTOMATIC RIFLE 15C MACHINE PISTOL W NAME ADDRESS (Street, Apt., City, State, Zip) PHONE z 00 1. 1. 1. V) U) Qa 2. 2. 2. ARREST/OFFENSE DESCRIPTION ARREST/OFFENSE CODE F/M & DEGREE WARRANT # ARREST LARCENY TYPE 1. 1. 23A POCKET PICKING 23B PURSE SNATCHING 2 2 2 2 2 23C SHOPLIFTING z0 23D THEFT FROM BUILDING 3. 3. 3_ 3. 3. 23E THEFT FROM COIN -OP MACH- I— 23F THEFT FROM MOTOR VEHICLE 4. 4. 4_ 4. 4. 23G MOTOR VEH. PARTS/ACCESS. lY 240 THEFT OF MOTOR VEHICLE Q 5. 5. 5. 5. 5. 23H OTHER: LL ? 'ARREST DATE TIME ARREST LOCATION (Street, Apt., City, State, Zip) F— W INCIDENT TRACKING NUMBER ARREST DISPOSITION BAIL fY R' MIRANDA WITNESSED BY: TIME READ FINGERPRINTED FINGERPRINT CARD NO. HOTOS TAKEN NO. TAKEN PHOTO ID NO. FBUBCI# ❑Y [I N ❑Y [3 N 'MULTIPLE ARRESTEE SEGMENTS INDICATOR 'ARREST 1 ❑ COMPLAINT 3 ❑ WARRANT 5 ❑ ORDER OF PROTECTION []COUNT ARRESTEE ❑ MULTIPLE ARRESTEE INDICATOR ❑NIA TYPE 2❑ IN -PROGRESS 4 ❑ SUMMONS 9 ❑ OTHER JUV. PARENT/ UY DATE/TIME NOTIFIED NOTIFIED BY `JUVENILE U HANDLED WITHIN THE DEPARTMENT GDN. NOTIFIED ❑ N DISPOSITION ❑ REFERRED TO OTHER AUTHORITIES J PARENT/GUARDIAN NAME AND ADDRESS (Street, Apt., City, State, Zip) RELATIONSHIP PHONE �1>z! = PARENT/GUARDWN NAME AND ADDRESS (Street, Apt, City, State, Zip) RELATIONSHIP PHONE PREVI DATE OF DATE OF NCIC # DATEffIME ENTERED } RUN/MISS. ❑N STCONTACT EMANCIPATION 3 LAST SEEN WEARING a z REPORTING OFFICER BADGE NO. DATE OFC.JUSTIN MENARD 761 01/10/2022 APPROVING OFFICER BADGE NO. DATE CAPT JOHN HASELEY 01/12/2022 nrnas COURT DATE