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Federal Bureau of Investigation Federal Bureau of Investigation
Home • Seeking Victim Information in Chad Butler Investigation

Seeking Victim Information in Chad Butler Investigation

Contact Information
Date of Birth  
/ /  

QUESTIONAIRE

1. I am filling this form out on behalf of:  


2. If filling out this form for a minor dependent(s), please provide the minor dependent's first name, last name, and date of birth

DOB
/ /  
3. Did you or a minor dependent(s) have contact with Chad Butler?



4. If yes, were you or the minor alone with Chad Butler, for any amount of time?


5. Did you or a minor communicate with Chad Butler via snapchat, other social media apps, text message, or by any means on the phone?


6. Did you or a minor communicate with any resource officer/law enforcement officer via snapchat, other social media apps, text message, or by any means on the phone?


8. Did you or a minor communicate with any adult staff at the school via snapchat, other social media apps, text message, or by any means on the phone? Examples of staff include but is not limited to teachers, principals, janitors, and counselors.


12. Are you aware of any other minors that may have had contact with school staff via phone or time alone?


Privacy Act Statement

The FBI is authorized to collect the information on this form by one or more of the following provisions: Title 28, United States Code, sections 533 and 534; Title 28, Code of Federal Regulations, section 0.85; and the Attorney General Guidelines for Victim and Witness Assistance. The information requested will assist the FBI in providing you with assistance to which crime victims are entitled under federal law. You do not have to provide the requested information; however, failure to do so may hinder the FBI in providing you with crime victim assistance. The information collected on this form is protected by the Privacy Act of 1974, as amended, Title 5, United States Code section 552a, and is maintained in the FBI’s Central Records System, DOJ/FBI-002, a description of which was published in the Federal Register at 63 Fed. Reg. 8671 (Feb. 20, 1998) and which may be viewed at www.justice.gov/opcl/doj-systems-records#doj