| Type of Incident: | Player |
| Match Number: | |
| Date of Incident: | 2013-11-24 |
| Time of Incident: | 12:20:00 |
| Location of Incident: | Woodward Park Field #6, Manteca, CA |
| Competition: | 2013_SOR_NCSC_ |
| Home Team: | ACC Mavericks Anarchy |
| Visiting Team: | San Ramon Azuri 03B |
| Age Group and Gender: | U11B |
| Team Affiliation of Individual Committing Incident: | San Ramon Azuri 03B |
| Incident Summary: | This should be submitted as send off report |
| Comments: | |
English