| Type of Incident: | Referee |
| Match Number: | 10133 |
| Date of Incident: | 2021-11-06 |
| Time of Incident: | 02:00:00 |
| Location of Incident: | Solano soccer complex |
| Competition: | 2021_SOR_FALL_ |
| Home Team: | Ref |
| Visiting Team: | CVFC 06G |
| Age Group and Gender: | U16G |
| Team Affiliation of Individual Committing Incident: | Ref |
| Incident Summary: | Complaint about the referee. |
| Comments: | This has been referred to Moe Shafai, the Head Referee of NorCal Premier. |
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