| Type of Incident: | Referee |
| Match Number: | |
| Date of Incident: | 2012-09-22 |
| Time of Incident: | 03:00:00 |
| Location of Incident: | Central Park #4 San Ramon Ca. |
| Competition: | 2012_SOR_FALL_ |
| Home Team: | San Ramon Azuri Force |
| Visiting Team: | AFC Velocity 99 |
| Age Group and Gender: | U14G |
| Team Affiliation of Individual Committing Incident: | |
| Incident Summary: | Send off protest |
| Comments: | This will be taken into account when ruling on Send off |
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