| Type of Incident: | Game Protest/Forfeit |
| Match Number: | 353 |
| Date of Incident: | 2015-11-07 |
| Time of Incident: | 10:00:00 |
| Location of Incident: | ceres river bluff park |
| Competition: | 2015_SOR_FALL_ |
| Home Team: | CERES EARTHQUAKE FC BARCELONA JRS |
| Visiting Team: | MERCED ATLAS 05B PREMIER |
| Age Group and Gender: | U10B |
| Team Affiliation of Individual Committing Incident: | CERES EARTHQUAKE FC BARCELONA JRS |
| Incident Summary: | Allegation an unlicensed referee was assigned to the match. |
| Comments: | Please provide the picture of the referee to the PAD Committee no later than noon on November 20, 2015. The picture should be sent to amittler@norcalpremier.com. |
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