r HI-TECH INVESTIGATION	r IDENTITY THEFT INVESTIGATION	r OTHER	
Agency and Case number #

	Case Filed with DA?     rYES   rNO

DA File #	County:	

Requesting Officer:	ID#	Phone:	Ext:	
E-mail Address:	
Crime code & description:	

SUSPECT INFORMATION	
	NAME: Last, First, Middle	DOB	SEX	ID#	ARREST (Y/N)	
Suspect 1						
Suspect 2						
VICTIM INFORMATION	
# of victims:	$ loss to victims:	

DETAILS OF REQUEST (Attach Additional Sheet If Necessary)	

INVESTIGATIVE INFORMATION	
Date of seizure:	Type of seizure:
r Search Warrant   r Probation   r Parole   r Consent   r Admin   r Other	
Consulted NC3TF Investigator ____________________________ rYes   r No   Re: r Case   r Search Warrant	
Has the evidence been previously viewed and/or accessed by anyone?  r Yes, Explain below     r No	
	
Are you aware of any privileged information contained within the evidence?  r Yes r No	

FORENSIC EXAMS ONLY

PRIORITIZE EVIDENCE ITEMS BY ORDER OF IMPORTANCE
	
ITEM #	DESCRIPTION	SERIAL #	

			

			

Please send this form along with the search warrant, affidavit and police report to: dhultquist@nc3tf.org or Fax: (707) 253-4664	

NC3TF Case Number: ____________________________