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MISSING PERSON REPORT FORM
Be advised submitting a report requires a background check for the cost of $150
Do you consent to a background check?
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Yes, and I acknowledge $150 background check fee.
Report Date
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Year
Date
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Hour
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Minutes
AM
PM
AM/PM Option
Your Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
Please Select
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
State
Zip Code
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Relation to the victim
*
Please Select
Parent/s
Son/Daughter
Legal Guardian
Sibling
Aunt/Uncle
Grandparent/s
Cousin
Family- Other
Friend/ Friend of family
Neighbor
Teacher
Boss/Coworker/Employee
None
Other
If no relation select "None"
Relation to Suspect
*
Please Select
Parent/s
Son/Daughter
Legal Guardian
Sibling
Aunt/Uncle
Grandparent/s
Cousin
Family- Other
Friend/ Friend of family
Neighbor
Teacher
Boss/Coworker/Employee
Witness
None
Other
If no relation select "None"
Upload a Copy of your State ID/DL
*
Take Photo
Front & Back
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REPORT INFORMATION -Click here to provide info
Report Type
*
Please Select
Missing Person
Predator - Online
Predator - in Person
Runaway- Minors only
Kidnapping by Parent
Kidnapping by Relative
Kidnapping by Unknown
Human/Sex Trafficking
Is the victim under 18 years old?
Yes
No
Description of what has happened?
*
Circumstances of Event, Last seen date/location, What you saw, Witnesses, Location etc
Incident Address
Street Address/ Description of location
Street Address Line 2
City
State / Province
Postal / Zip Code
Was a report made to Law enforcement?
*
Yes
No
Attempted
If Selected "Yes" above Please provide the following:
Name of Law Enforcement Agency
Case/Incident #
Name of Detective/ Officer assigned to your case
VICTIM INFORMATION -Click here to provide info
Victim's Name
First Name
Last Name
Victim's Address
Street Address
Street Address Line 2
City
Please Select
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
State
Zip Code
Date of Birth
if unknown provide approx age
Hair Color/ Hair Description
length, curly, straight, shape, style etc
Approx. Height
Approx Weight
Please Select
Under 50 lbs
51-100 lbs
101-140lbs
141-170lbs
171-200lbs
201-240lbs
241-270lbs
271-300lbs
301-340lbs
341-370lbs
371-400lbs
401-440lbs
441-470lbs
471-500lbs
Over 501lbs
Race/Ethnicity
Please Select
Black or African-American
Caucasian
Hispanic/Latino
Asian
Native American
Uknown
Eye Color
Please Select
Brown
Blue
Green
Hazel
Uknown
Gender/Presenting
Please Select
Male
Female
Male Presenting
Female Presenting
Tattoos/ Piercings
Description, Body location
Employer/ Business/ School
Name of Employer, Business, School
Employer/Business/School Address
Photo of Victim
Upload Image
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SUSPECT INFORMATION -Click here to provide info
Is the suspect known or Unknown?
Known - Provide all info that is known otherwise leave blank
Unknown
Suspect's Name
First Name
Last Name/Business Name
Suspect's Address
Street Address - If unknown type UK
Street Address Line 2
City
Please Select
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
State
Zip Code
Date of Birth
if unknown provide approx age
Hair Color/ Hair Description
length, curly, straight, shape, style etc
Approx. Height
Approx Weight
Please Select
Under 50 lbs
51-100 lbs
101-140lbs
141-170lbs
171-200lbs
201-240lbs
241-270lbs
271-300lbs
301-340lbs
341-370lbs
371-400lbs
401-440lbs
441-470lbs
471-500lbs
Over 501lbs
Race/Ethnicity
Please Select
Black or African-American
Caucasian
Hispanic/Latino
Asian
Native American
Uknown
Eye Color
Please Select
Brown
Blue
Green
Hazel
Uknown
Gender/Presenting
Please Select
Male
Female
Male Presenting
Female Presenting
Tattoos/ Piercings
Description, Body location
Employer/ Business/ School
Name of Employer, Business, School
Employer/Business/School Address
Photo of Suspect/s
Upload Image
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If any additional individuals involved please list them below:
Other Required
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150.00
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