| Type of Incident: | Referee |
| Match Number: | |
| Date of Incident: | 2012-12-09 |
| Time of Incident: | 09:05:00 |
| Location of Incident: | fallon sprots park field 2 |
| Competition: | 2013_SOR_NCSC_ |
| Home Team: | fc milpitas |
| Visiting Team: | alpine strikers FC00B red |
| Age Group and Gender: | U12B |
| Team Affiliation of Individual Committing Incident: | |
| Incident Summary: | Complaint regarding referees at NorCal State Cup match assigned by Dublin United |
| Comments: | |
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