Your Name:                       

Your Email Address:          

Your Address:                   

City, State and Zip Code    

Daytime Phone:      Night-Phone: 

Cell Phone:                       Pager: 

How were you referred to our office?: Choose a Referral Source Search Engine Another Client OPIA PI Resource Locator KTUL Website The PI Mall Phone Book Friend Other
Please specify:

How would you like us to contact you?: Choose Contact Method Telephone E-Mail Pager I will contact your Office
Please specify:

Your Place of Employment:
Employment Address:

What is the Nature of this Investigation? Choose Type of Investigation Divorce Infidelity/Adultery/Cheating Mate Child Custody Criminal Research Civil Litigation Other Explain Below

Do you have any restraining orders against YOU? No Yes

How are you related to the subject?

ATTORNEY INFORMATION:

Have you hired an attorney as of yet? Choose an Answer Yes No I am Planning To I need a referral
Name of attorney?
What is his/her telephone number?

Has the Subject of this investigation hired an attorney as of yet? Choose an Answer Yes No I am not sure
Name of Subjects attorney?
What is his/her telephone number?
Has any legal papers been filed in this case? Choose an Answer Yes No I am not sure
What is the nature of the court filing that has already been done?

SUBJECT INFORMATION

Who is the subject of this investigation?

Home Address:
City, State & Zip:
Daytime Phone :      Night-Phone :
Cell Phone :      Pager:

Employment:
Work Address:
City, State & Zip
Type of Job/Duties
Work Hours       Breaks

Subject's Description & Personal Information:
Age:      Date of Birth      Sex  Choose Gender Male Female
Race:      Height       Weight
Hair Color      Hair Style
Facial Hair?      Glasses?      Contacts?      Other
Social Security # Driver's License # State

Does the Subject have any Known Scars or other Identifying marks or behavioral habits that we should be aware of?

What type of vehicle(s) does the Subject drive?
     License #
     License #
     License #
     License #

Subject's Friends, Hangouts:

Please provide names and addresses of friends of the subjects...Places he/she might go to hangout. Free form is provided for your input.

NOTE: Do not type in more information than can be seen on the screen as it will not print out!

Place 1.

Place 2

Place 3

Place 4

IS THE SUBJECT AWARE OF YOUR INVESTIGATION? Choose an answer Yes No I am not sure
If yes or not sure please explain:

DETAILED EXPLANATION OF WHAT YOU WOULD LIKE US TO DO:

OTHER INFORMATION THAT WOULD BE HELPFUL TO HAVE: Phone bills, Cellular telephone billing, Pager billing, Pictures, and any other information that you might have on the subject.

REMEMBER: What you already know is valuable, only if you communicate it to us. If you have information that would be helpful to the investigation, you can save money by providing that upfront.

You may print out the form and fax to (405)282-1329 OR
click on the "Submit Form" button to E Mail the information to us.