Surveillance Intake Form
(843)213-8986 intake@immaculatepi.com
Client Information
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Method of Communication?
Phone
Email
in person
zoom
Occupation
If you have retained an Attorney please include their name. No attorney = n/a
*
How Much do you have set aside for this project?
Please Select
Under $5,000
$5,000-$10,000
$10,000-$25,000
Over $25,000
Deadline
HOW DID YOU FIND US?
*
Please Select
GOOGLE SEARCH
ATTORNEY
PREVIOUS CLIENT
FRIEND
SOCIAL MEDIA
ADVERTISEMENT IN MAIL
Subject Information (person we are doing investigation on)
Name
First Name
Last Name
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth if known
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
SSN if known
Occupation
Work Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Vehicle Info
GPS Authorized?
Please Select
yes
no
Cameras at Residence?
Please Select
yes
no
unknown
Dogs?
Please Select
yes
no
unknown
Schedule
Social Media
History of Violence or Abuse for either party?
Please Select
yes, subject
yes, client
neither
Paramour information
(person spouse is cheating with)
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
DOB/ Age estimated if known
Vehicle information
How long have you suspected this person to be involved with your spouse? (adultery cases only)
What makes you believe there is an affair going on? (adultery cases only)
Social Media
Any other information that you deem helpful to begin the investigation (schedule etc)
Submit
Pictures or Documents that Investigator should have- Please at least include a picture of subject.
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