| Type of Incident: | Sportsmanship — May be used if a team, player, coach, or spectator is involved. |
| Date of Incident: | 2019-09-22 |
| Time of Incident: | 06:00:00 |
| Location of Incident: | San Juan Soccer Complex Field White |
| Home Team: | San Juan Light 06 Blue |
| Visiting Team: | 49er |
| Age Group and Gender: | U14B |
| Team Affiliation of Individual Committing Incident: | San Juan Light 06 Blue |
| Incident Summary: | Player sent off for DOGSO. |
| Comments: | This should not be filed as a PAD Incident Report, but rather as a send-off report. If not done already, the referee must fill out the send-off report. |