Document 6527669

Appendix 2 – Sample NPA01 form
NON-POLICE AGENCIES
(Notification of Proceedings to Police)
AGENCY NAME: HEALTH & SAFETY EXECUTIVE
AGENCY REF. No: [COIN case no]
ADDRESS: [insert local office address]
number]
: [insert local office contact
OFFICER IN CHARGE OF CASE: [Litigation Officer]
SIGNATURE:________________________
For Police Use Only A/S Reference Number
PNC Court Case Reference Number
The NPPA will document this for Bichard 7 Solution
PNC
ID Number
CRO
Number
Entered on PNC by
Date
Name Charged/Summonsed
Surname
Forename(s)
Alias Name(s)
Nickname
Date of Birth
Sex
M
Colour
F
Place of
Birth
Reported
Photograph
Taken
DNA Sample
Prosecuting
Agents
White
Taken
Arrested
Non White
British
Nationality
Process
Stage
Height (Imperial)
Summoned
X
Time
Date
Fingerprints
Mouth
m
in
Driver
Number
Not Taken
Not Taken
ft
or Metric
Hair
Taken
Not Taken
ID Number
Health and Safety Executive
Offence (in plain language,
include Act & Section of
Offence.)
[insert offence wording from table – eg “Employer breaching general duty to employee, s33(1)(a) & 2 Health and
Safety at Work etc Act 1974”]
Offence Start
Date/Time
Offence End
Date/Time
Address/Location of Offence
County
Postcode
Method used in Offence
(Show as much information as possible especially in regards to words spoken/weapons used/means of entry/exit and
part played by any ACCOMPLICE showing name and address where known.)
[Base upon the allegation in the information, amending where necessary to aid third-party understanding]
*****
FOR ADDITIONAL OFFENCE(S) USE A SEPARATE FORM NPA 02
Continuation form(s) NPA 02 attached
Charged/Summonsed
on date
Yes
Court Date
*****
No
Time
Court
Name
Cautioned on date
Cautioning Officer
Rank
Surname
Name
Cautioned
Ethnic
Appearance
Forename(s)
White
Europea
n
Dark
European
Afro
Caribbean
Asian
Oriental
Arab
Unknown
Fat
Heavy
Stocky
Broad
Thin
Slim
Small
Grey
Hazel
Pink
Unknown
Right
Handed
Left
Handed
Ambidextrous
Build
Medium
Proportionate
or
Shoe Size
Eye
Colour(s)
Blue
Brown
Green
Glasses
Glasses
Contact
Lenses
Neither
Type
Colour (1)
Handed
Dyed/Greyin
Colour (2)
Features
Hair
Bald
Collar Length
Cropped
Receding
Short
Shoulder L’th
Very Long
(BA)
(CL)
(CR)
(RE)
(SH)
(SL)
(VL)
Moustache
Beard
Long
Sideburns
Clean Shaven
(M)
(B)
Black
White
Light Brown
Dark Brown
Fair
Blonde
Ginger
Auburn
Grey
Brown
Red
Sandy
Mousey
(BK)
(WH)
(LB)
(DB)
(FA)
(BD)
(GI)
(AU)
(GY)
(BR)
(RD)
(SA)
(MO)
Dyed
Greying
(D)
(G)
Black
White
Light Brown
Dark Brown
Fair
Blonde
Ginger
Auburn
Grey
Brown
Red
Sandy
Mousey
Blue
Green
Orange
Purple
Yellow
Pink
Multi
(L)
(C)
Type
Colour (1)
Dyed/Greyin
(BK)
(WH)
(LB)
(DB)
(FA)
(BD)
(GI)
(AU)
(GY)
(BR)
(RD)
(SA)
(MO)
(BL)
(GN)
(OR)
(PU)
(YE)
(PI)
(MU)
Colour (2)
Afro
Plaited
Mohican
Beehive
Ponytail
Punk
Rasta
Shaven
Skinhead
Teddy
Permed
Curly
Wavy
Dirty
Greasy
Streaked
Thinning
Wig
Straight
Untidy
(AF)
(PL)
(MO)
(BH)
(PT)
(PK)
(RA)
(SV)
(SK)
(TE)
(PM)
(CU)
(WA)
(DI)
(GR)
(SD)
(TH)
(WI)
(ST)
(UT)
Features
Facial
Hair
Accent
English
North West
Liverpool
American
West Indian
Marks/Scars/
Abnormalities
Scottish
Yorkshire
Birmingham
Australian
Asian
TATT
MARK
LACK
SCAR
PRCD
PECU
Tattoo
Lacking
Scarred
Pierced
Peculiar
Irish
Midland
London
French
Oriental
R
L
C
U
W
Welsh
East Anglia
Glasgow
German
Foreign Other
Right
Left
Centre
Upper
Lower
SCAL(Scalp)
EYES
LIPS
NECK
BACK
ARMS
Northern
West Country
North East
Southern
Italian
Cultured
Spanish
LEGS
GAIT
BROW
EARS
TEET(Teeth)
CHES(Chest)
GENI(Genitals
HAND
FEET
SPEE(Speech
FACE
NOSE
CHIN
ABDO(Abdomen
BUTT (Buttocks)
FING (Finger)
TOES
TONG (Tongue)
Description (describe tattoo or other details)
Home Address(es)
Other Address(es)
Postcode
[or registered address for companies]
Postcode
Type
Number
Identity Numbers
(DSS/National Insurance etc.)
Occupation
Date
Habitual Dress
Jewellery Worn
State if worn permanently
and body position
Habits/Mannerisms
Special skills
Bracelet
Watch
Brooch
Pendant
Earring
Other
Neck
h i
Pin
Ring