Form

Your Details: Please supply your full contact information. Note: fields marked with an * are required and must be completed.

Name

First NameLast Name

If Applicable

Address

Address 2

City

State

Zip Code

Country if non US

Telephone

If Applicable

Fax

Email Address

Date

State DriverDates License

Best time to contact:

AMPMOther

Preferred contact method

PhoneEmailMail

Investigation Type: Please choose one which best describes your request. Check the box to the "left" of the service desired.

Reason for Request Please outline the reason you require this investigation.

Relationship to Subject Family Friend Creditor Employer etc

900 Bugg Lane, Ste 240 San Marcos, Texas 78666 Office: 512.667.6187Fax: 512.714.5035

Capital Investigation Services

Subject Details Please provide as much information as possible about the subject or your investigation.

Your CaseFile

Full (Proper) Name: (Example: John Q. Public)

First NameLast Name

or Company Name

Last Known Address

Address2

City

State

Zip

if non US

Phone Number

Please enter a valid phone number.

E-mail Address: (johndoe@aol.com)

example@example.com

Gender:

Date of Birth or Approximate Age

MonthDayYear

Marital Status Single Married Divorced Separated or Widowed

Automobile Make: (Ford, Mercedes-Benz, Pontiac, GM) etc.

Automobile Model: 2 door, 4 door, SUV, Pickup, Truck etc

Automobile color

Automobile Registration / Tag

State of Registration

Height: feet inches

Weight: lbs.

Hair Color: Length/Style:

Eye Color

Race: (White, Black, Hispanic, Asian e.g.: Chinese), etc.

Scars Tattoos Piercings etc

900 Bugg Lane, Ste 240 San Marcos, Texas 78666 Office: 512.667.6187 Fax: 512.714.5035

Other Details:

Capital Investigation Services

Please include below ANY further information you know about the subject, such as the High school or college attended, type of work they do (or did), city or state of birth, what city or state you believe or know they live in now, professional memberships i.e. unions, accountant, dentist, likes and dislikes, hobbies, etc. EVERY detail you can give may help us solve your case more quickly.

Use discretion when contacting me

Please note: Submitting this form does not constitute a contract or agreement that Capital Investigation Services will perform any services on your behalf. Once we receive your information, we will review your case and an agent will contact you by the method you have chosen above to discuss your options. All information supplied is kept strictly confidential. A case is considered accepted when an INVESTIGATIVE SERVICES AGREEMENT has been fully executed and submitted to Capital Investigation Services. If the client elects not to, or fails to, complete and submit the INVESTIGATIVE SERVICES AGREEMENT, the client acknowledges and approves that the standard (default) published provisions of the agreement will apply. Only the final written quoted rates and costs fields may be modified for the purposes of the standard (default) published INVESTIGATIVE SERVICES AGREEMENT.

By submitting this online form, I hereby certify and affirm that the information supplied above is true and accurate to the best of my knowledge at this time. I further represent and affirm that I am authorized to order and financially contract for this assignment and am not prohibited by any court order to conduct said investigation. I understand that my knowingly supplying false or misleading information may result in my case being rejected. I will forfeit any and all funds that may be paid to the Agency pertaining to this case if any information is discovered to be false, misleading, or compromising the ethical and/or legal obligations of the agency.

900 Bugg Lane, Ste 240 San Marcos, Texas 78666 Office: 512.667.6187 Fax: 512.714.5035

Other Request:

Please send literatureUse discretion when contacting me

CIS AUSTIN

Capital Investigation

CIS AUSTIN