Requester Information

First Name  

Last Name  

Desk Phone

Cell Phone  

Email Address  

Agency Information

Agency Name  

Address

City

State   Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ------------------- America Somoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico Virgin Islands

ZIP Code

Questions

1. Have you discussed this case with a CAST agent?

Yes
No

1a. If yes, who?

2. Type of Criminal Investigation (Select all that apply)

Assault

Armed robbery

Arson

Child abduction

Corruption

Child exploitation

Criminal enterprise

Cyber intrusion

Drug-related

Financial/white-collar

Fugitive

Gang investigation

Home invasion

Homicide

Homicide – attempted

Human trafficking

Kidnapping/hostage-taking

Missing person

Sexual assault

Other

2a. If Other, please specify.

3. Location of the Crime Latitude and longitude accepted.

4. Other Pertinent Locations Please list any other relevant locations. Latitude and longitude accepted.

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5. Date and Estimated Time of Crime   (e.g., December 15, 2012, 11:03 a.m.)

6. Beginning Date and Time for Analysis Request   (e.g., December 14, 2012, 1:00 a.m.)

7. Ending Date and Time for Analysis Request   (e.g., December 16, 2012, 11:00 p.m.)

8. Case Status

Ongoing investigation/Not yet in custody
Subject(s) arrested/indicted/pre-trial
Trial date set
Other

8a. If Other, please specify.

9. Trial Date (If Set) (e.g., December 15, 2013)

10. Case Summary Please provide a very brief, high-level, unclassified synopsis of the case.

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