Detailed Assignment Description for Forensic Report #2
( Property Record Number: ___ XXXX _______ )
Your Organization / Company, LLC EVIDENCE CHAIN OF CUSTODY TRACKING FORM
Case Number: ______xxxx_____________ Offense: _________________
Submitting Officer: (Name/ID#) _Private Investigator Smth, Badge #351
Victim: __Joe________________________________________________
Susct: _Fred_________________________________________________
Date/Time Seized: _08/20/2016; 0630hrs (MDT) Location of Seizure: 123 Main Street, Denver, CO 80135
|
Description of Evidence |
||
|
Item # |
Quantity |
Description of Item (Model, Serial #, Condition, Marks, Scratches) |
|
1 |
1 |
Verbatim USB Drive, black, 2.0GB, Serial #23097JR2. Marked as “USB02_032816_4-2”. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Chain of Custody |
||||
|
Item # |
Date/Time |
Released by (Signature & ID#) |
Received by (Signature & ID#) |
Comments/Location |
|
1 |
08/21/16 |
PI Smith, #351 |
Examiner, #891920 |
Released for processing at forensics lab. |
|
1 |
08/22/16 |
Examiner, #891920 |
Jane Smith, evidence custodian |
Secured in evidence locker awaiting final disposition. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
EVIDENCE CHAIN-OF-CUSTODY TRACKING FORM (Continued)
|
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 rtaining to (susct): ____________________________________________ 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 nalty 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 rmanent record by the Anywhere Police Department. |
|
|
APD_Form_#003_v.1 (12/2012) Page 2 of 2 pages (See front)