****

FILED: BROWARD COUNTY, FL Brenda D. Forman, CLERK. 1/25/2023 12:07:50 PM.****

Broward County Sheriff's Office .-

6,-
&: ==i
E nu.
23- 864 FO F
Booking Report ZDZKHAQL?
CIS# 232300166 BCCN # 959131 Booking Sheet Control Date and Time

OBTS 607318670 Print Clearance 01/24/23 17:07:27 Prints Yes 01/24/23 20:00:36

Arrest # PB 2300166 Offense Report # 112301007982 Agency POMPANO BEACH

Last Name SSN #

First
SAMPSON, CORNELIUS
Middle

Race Sex Height Weight Eyes Hair Comp. Age Admitted DOB Place of Birth State FDLE

B M 510 300 BRO BLK DBR 19 10/24/2003 0

Permanent Months of Residence

Address 2380 NW 31 ST AVE FT LAUDERDALE FL 33311
0

ArrestDate 01/24/23 14:17:00 Place of Arrest 1010 NW 31 ST AV Arresting Officer 19597 DAVIS

Inmate Logged Date 01/24/23 16:39:34 Inmate Log Type FULL INTAKE Place Admitted MAIN

Intake Comments SP/CO-1850629/54-17587 WC-15762

Alias Last name, First, Middle, DOB

Warrants Officer Id: bs15762

Scars,Marks,Tattoos

Release Date/Time Release Reason ReleaseAuthorized By

Charge No. Charge Initiation Date Statute WarranVCapias Level M.C B. Type Bond Amount
1 01/24/23 19:57 784.081-2c(1) 3F Y HOLD FOR MAG $0.00

Charges BATTERY ON PUBLIC OR PRIVATE EDUCATION Comments

EMPLOYEE

Booking Off. ID bs18236 County Judge

* *
End of Report
 ****
FILED: BROWARD COUNTY, FL Brenda D. Forman, CLERK 1/35/2023 12:07:50 PM. *-=P

di..
O COMPLAINT AFIDAVIT
SHADED FIELDSMUST BE ANSWERED IF DEFENDANT NOT IN'CUSTODY M ARREST FORM
BROWARD COUNTY
ARREST # OBTS #
' -
?

Lrll?
Filing Agency Offense Report
1i,464'JD#? iii':
:i c, 4 MLG!;1"! ..'.. .,Ii'1,11itmi,i "FVTTdf7919"? '::. tllili, ?O? UL( j
i'..rh/1'
Defendant'sLast Name First Middle SUF Alias/Street Name Citizenship
SAMPSON (/ b- L/ CORNEUUS US
Race Sex Hgt Wgt fyesG-' iomH- Age DOB Birth Place

'B. 2 8 0 BiK .= d2 5. iz4/2003

Permanent Address Scars, Marks, TT

2380 NW 31ST AV, FORT LAUDERDALE, FL 33311

-

Residence-Type: (1) City (2) County Local Address: Place of Employment Length
23&0NW 31ST AV, FORT
.

1[3) Florida'. (4) Out of State

LAUDERDALE,FL 33311
How long defendant In Breathalyser By/CCN Reading Place of Arrest Date/-Time Arrested Arresting Officer(s) CCN
Broward County'
1010 NW 31ST AV 01/24/2023 14: 17 DAVIS, CLEVONNE C. (19597)
Officer injured YON ? Unit Zone Beat Shift Trans. Unit PMD YM NO TransportingOfficer/CCN Pick-upTime Time Arrived/BSO
SRO 1119 BRAV
IMQE? E-Heroin P-Paraphernalia/ M-Manufacture/
TYPE / ACTIVITY: 8(1!-MlhG T-Traffic Indicationof Y N UK
N-N/A H-Hallucinogen Equipment N-N/A Produce/Cultivate
A-Smuggle Alcohol Influence O G O
A-Amphetamine M-Maryuana S-Synthetic P-Possess D-Deliver K-Dispense/
i
n3/a//
B-Barbiturate O-Opium/Deriv U-Unknown S-Sell Distribute Drug Influence
E-Use
C-Cocaine Z-Other B-Buy Z-Other

?fl.-.LZ
''1 1:!.
-1: lrll ? ,;,,, +'"' 4 :1,1!: "E+dHf
1

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Attach 5
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1 1. 4.
Defendant's 14 Vehicle TowedTo:

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i,' SILIYNI,11* ?Il???1!E'iI. . 133F3
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Photo :.::..
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AA.'i 3 15 A:Q
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REDACTED of victim(s) (If corporation exact le al name and state of Incor oration)
4

Count # Offenses Charged M WC# / Citation # (if applicable) 1 FS or Capias/Warrant #

Before me this date personallyappeared DA WS CLEFONNEC (19597) who being first duly sworn deposes and says that on
24 dayol January ,Wear) at REDACTED 2023
(crime location)
the above named defendantcommittedthe above offenses charged and the facts showingprobable cause to believethe same are as follows:

On 01/24/2023 I was alerted by security that a 12th grade student (Corneilus Sampson)
had battered a school therapist (Bridget Cormier).

Ms Cormier advised she was talking to one of the behavipral technicians as Mr Sampson
was walking by. REDACTED stated she was having a conversation about one of, her
previous students who was involved in a crime. She stated she believes, Mr Sampson
* * * ***
Continued
of I have read the foregoing and that,the factsstated therein are true and correctto the best of my knowledge and belief.
Undnalties perjulL54that
DAVISgLEVONNEC. (19597) PompanoBeach
Officer/Affiant'sSignatufe Officefs Name/CCN Officer's Division

STATE OF FLORIDA
COUNTY OF BROWARD
'

Sworn to (or affirmed)and subscribedbefore me this '24 day Gi January 2023 (year),
by. DAVIS. CLEVONNE C. (name and title), who is personally known to me or has produced .-
5: ,
/d JAN 74
as identification.
I,e.'1

Cled n'LRIAOLRRO 19408

Notary Public, Deputy Clerk of the Court, or AssistantState Attorney Title/Rank and CCN

CJ.Iwd MarSIa//
Print, Type or Stamp CommissionedName of Notary Public (SEAL)
Seventeenth Judicial Circuit
FIRST APPEARANCE/ARRESTFORM Org -
Coun
Broward County
2nd -
State Attorney
State of Florida
3rd -

Filing Agency
(SHOULD ADDITIONALSPACE BE NEEDED, USE THE PROBABLE CAUSE AFFIDAVIT CONTINUATION (BSO DB#2a))
BSO DB-#2 (Revised 05/00)
4th -

Arresting Agency

COURT COPY

29154017587 WC-1522
 .
,
if

O COMPLAINT AFFIDAVIT
PROBABLrbAush AkFIDAVITCONTINUATION B ARREST FORM
OUNTY
'T # OBTS #
'1 'i Ii:@...: ..1.1
Filing Agency Offense Report t
6*i, 0'8
'.,-LG
'I IlilR*i*"p';1;.. '4r'
"
'i:
111 ;1 lilliI,i,, "'i?14 Mi :I!17
M#i
BROWARDCOUNTYSO 11-2301-007982 &;..PA
Defendanfs Last Name First Middle SUF Alias/Street Name Citizenship
SAMPSON CORNELIUS US
Name of vict#n(s) (if corporation, exact legal name and state of incorporation)

Count# Offenses Charged WC# / Citation # of applicable) FS or Capias/Warrant#

** *
SEE PAGE 1

Before me this date personally appeared DAVIS, CLEVONNE C. (19597) who being first duly sworn deposes and says that on
24 January 2023 at 1010 NW 3IST AK POMPANO BEACH, FL 33069
day of , Weao crime location)
the above named defendantcommittedthe above offensescharged and the facts showing probable cause to believe the same are as follows:

thought she was talking about him and that's when he turned around and aggressively
walked toward REDACTED . She stated she tried to avoid his path but Mr Sampson used
both hands and shoved her into the fence. REDACTED suffered a laceration to the right
elbow and complained of head pain (EMS Declined).

-m,Mr Sampson is diagnosed with autism.

REDACTED stated she does want to peruse charges against Mr Sampson. Mr Sampson was

taken into custody and transported to the BSO main jail.

l sweir the above statementhgou=land true to the best of my knowledgeand belief

DAVIS. CLEVONNE C. (19597) Pompano Beach

Dfficer/Affianfs Signature- Omcefs Name/CCN Officefs Division

STATE OF FLORIDA
COUNTY OF BROWARD
Sworn to (or affirmed)and subscribedbefore me this 24 day of Januarv 2023 (year),
by DAVIS, CLEVONNE C. (name and title), who is personally known to me or has produced

as identification.

C.IUG MDVWLqzD
Notary Public, Deputy Clerk of the Court, or AssistantState Attorney
iqyoo
Title/Rank and CCN

Ctwid Marshuli
Print,
Type Stamp Notary
or CommissionedName of Public (SEAL)
Seventeenth Judicial Circuit
FIRST APPEARANCE/ARRESTFORM Orig -
Court
Broward County
2nd -
State Attorney
Slate of Florida 3rd -

Filing Agency
BSO DB-#2a (Revised 05/00) COURT COPY 4th -

Arresting Agency