IMMEDIATE: Needed 6 November at 15

Description of Evidence

Item #

Quantity

Description of Item (Model, Serial #, Condition, Marks, Scratches)

Chain of Custody

Item #

Date/Time

Released by (Signature & ID#)

Received by (Signature & ID#)

Comments/Location

Chain of Custody

Item #

Date/Time

Released by (Signature & ID#)

Received by (Signature & ID#)

Comments/Location

Final Disposal Authority

Authorization for Disposal Item(s) #: __________ on this document pertaining to (suspect): ____________________________________________ is(are) no longer needed as evidence and is/are authorized for disposal by (check appropriate disposal method) ☐ Return to Owner ☐ Auction/Destroy/Divert Name & ID# of Authorizing Officer: ____________________________ Signature: ______________________Date: _______________

Witness to Destruction of Evidence

Item(s) #: __________ on this document were destroyed by Evidence Custodian ___________________________ID#:______ in my presence on (date) __________________________.

Name & ID# of Witness to destruction: ________________________ Signature: ______________________Date: _______________

Release to Lawful Owner

Item(s) #: __________ on this document was/were released by Evidence Custodian ________________________ID#:_________ to Name _____________________________________________________________________________ Address: ________________________________________________ City: ____________________State: _______ Zip Code: __________ Telephone Number: (_____) ___________________________________ Under penalty of law, I certify that I am the lawful owner of the above item(s).

Signature: _______________________________________________________ Date: __________________________ Copy of Government-issued photo identification is attached. ☐ Yes ☐ No

This Evidence Chain-of-Custody form is to be retained as a permanent record by the Anywhere Police Department.