Evidence Submission

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Inspector Stephen Lear

USPIS/NCMEC
Post Office Box 19853
Alexandria, VA 22302-9853

Case Information:
Case Number: Enter Case #
Suspect Name: Enter Suspect's Full Name

Submitted Media:
Enclosed you will find Enter# of disks submitted Choose media type
(CD, DVD, hard copies, VHS)containing approximately Enter # of
image files submitted image files and Enter # of movie files submitted
movie files to be reviewed for identified child victims.

Known email addresses and/or screen names of suspect:


List screen names and email addresses used by suspect

Related CyberTipline reports:


List any related CT reports to this case

Is this a RUSH case? Yes No


If yes, please list date needed

Brief Case Summary


Provide brief case summary of case

Submitting Law Enforcement Agency Information:


Officer/Agent Name
Agency Name
Address
Address 2
City/State/Zip
Phone number
Email Address

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