CONFIDENTIAL

BIN INFORMANT PROFILE SHEET

(DI Form 001)

Operation/Project:

Action Agent
Code Name:
Source Code:

Witting Informant
Code Name:
Source Code:

Un witting Informant

Name: Nickname/Aliases:
Place of Birth: Birth Date:
Highest Educational Attainment/School:
Present Address:
Occupation: Position/Title
Name and Address of Employer:
Name of Spouse: Birth Date:
Name of Children: Birth Date:

Prepared By:

Informant/Action Agent: _______________________ ________________

(Signature over Printed name) (Date)

Primary Handler: _______________________ _________ ________________

(Signature over Printed name) Badge # (Date)

Unit/Designation: ____________________________

Approved By: _________________________ _________ ________________

(Signature over Printed name) Badge # (Date)

Unit/Designation: ____________________________

CONFIDENTIAL