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Branch Goodwater
Retired Chief Of Police
Retired Chief Of Police
Posts: 2596
Joined: Tue Jul 10, 2018 1:47 am
Primary Assignment: Office of the Chief of Police
#365140
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LOS SANTOS POLICE DEPARTMENT
TRAFFIC DIVISION

APPLICATION FOR WINDOW TINT EXEMPTION
INDIVIDUAL EXEMPTION FORM


PART I.
  1. FIRST NAME: Branch
  2. SURNAME: Goodwater
  3. ADDRESS (NUMBER & STREET): Redacted
  4. CITY: Los Santos
  5. STATE: San Andreas


VEHICLES TO BE REGISTERED FOR EXEMPTION:
Maximum of 2
  • Vehicle: Grotti Carbonizzare
    Plates: GOODH20
  • Vehicle: Grotti GT-500
    Plates: FGT250



PART II.

MEDICAL DIAGNOSIS FOR EXEMPTION:
Skip if not applicable | (( Convert cb to cbc for a checkmark ))

Abinism
Chronic actinic dermatitis/actinic reticuloid
Dermatomyositis
Lupus erythematosus
Porphyria
Xeroderma (pigmentosa) pigmentosum
Severe drug photosensitivity provided that the course of treatment causing the photosensitivity is expected to be of prolonged duration
Photophobia associated with an ophthalmic or neurological disorder
If other condition or disorder causing severe photosensitivity in which a person is required to be shielded from sun rays for medical reasons, please fill the field in below:
Other: -

EVIDENCE OF MEDICAL DIAGNOSIS:
Medical diagnosis must provide the certified medical provider's name, examination date (must be within one month of from the date this form is submitted to the LSPD), and clinic name. Certified medical professional must have a San Andreas certification.

** ATTACHED DOCUMENTS IF APPLICABLE. **

ACCESS
ACCESS
ACCESS

EXEMPTION FOR CREDIBLE THREAT:
Credible threat is gauged by submitting a Crime Complaint Report to the Area Detectives Division. Once the Crime Complaint Coordinator has reviewed the presented evidence, they will inform the Traffic Division of approval or dismissal of the application for window tint exemption.

I confirm I have emailed the Crime Complaint Coordinator with a Crime Complaint regarding a credible threat.
Date Complaint Filed: DD/MMM/YYYY


PART III.

I certify and affirm that all information presented in this form is true and correct, that any documents, including supporting documentation that I have presented to the Los Santos Police Department are true, accurate, and genuine. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal offense.

Signature of Vehicle Registrant:
Sign Name in Full

X Branch Goodwater

Date:
24/JAN/2022

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Jarmin Russ
Retired Police Lieutenant
Retired Police Lieutenant
Posts: 1365
Joined: Sat Oct 14, 2017 1:47 pm
Primary Assignment: Traffic Division
#367674
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LOS SANTOS POLICE DEPARTMENT
TRAFFIC DIVISION

To Mr Goodwater,
  • Your application has been received and acknowledged by the Traffic Division. Your application will be reviewed within 24-48 hours of receiving this notice.

    Please remain patient during this time and do not contact any Traffic Division members in attempts to speed up the process as this can result in your application being denied.

Respectfully,

Police Lieutenant II Jarmin Russ
Division Commander
Traffic Division
User avatar
Jarmin Russ
Retired Police Lieutenant
Retired Police Lieutenant
Posts: 1365
Joined: Sat Oct 14, 2017 1:47 pm
Primary Assignment: Traffic Division
#367679
bwlspdlogo
LOS SANTOS POLICE DEPARTMENT
TRAFFIC DIVISION

To Mr. Goodwater,
  • We are pleased to inform you that all pre-approval checks have now been resolved and that your application for tint exemptions has been APPROVED. Please contact a member of the traffic division to have your certificates issued in person.

    Please keep all certificates within the glove box of the matching vehicle and provide the document to any Law Enforcement Officer if detained in connection with the vehicle. Upon expiry of the certification, a new application for tint exemption may be made.
Respectfully,

Police Lieutenant II Jarmin Russ
Division Commander
Traffic Division