| Type of Incident: | Other — Do not use if a team, player, coach, or spectator is involved. Use only if the incident cannot be classified as any other Type of Incident above. |
| Match Number: | 1650 |
| Date of Incident: | 2021-09-18 |
| Time of Incident: | 03:10:00 |
| Location of Incident: | Turlock Sports Complex |
| Competition: | 2021_SOR_NCSC_ |
| Home Team: | Luis Mena(Fuego Fc Manager) |
| Visiting Team: | TSP(friendly team) |
| Age Group and Gender: | U11B |
| Team Affiliation of Individual Committing Incident: | Luis Mena(Fuego Fc Manager) |
| Incident Summary: | Alleged referee assault. |
| Comments: | This has been forwarded to USClub Soccer for referee assault. Luis Mena is suspended indefinitely until the hearing by USClub Soccer. |
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