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Thank you for submitting your Evidence Transmittal online.
SUBMIT AN EVIDENCE TRANSMITTAL ONLINE
ORIGINAL REPORT & INVOICE TO:
Name:
REQUIRED
Please provide your full name.
Organization Name:
REQUIRED
Please provide the name of your organization.
Address Line 1:
REQUIRED
Please provide the first line of the address for your organization.
Address Line 2:
Please provide the second line of the address for your organization.
City:
REQUIRED
Please provide the city for your organization.
State/Province:
REQUIRED
Please provide the state or province for your organization.
Postal Code:
REQUIRED
Please provide the postal code for your organization.
Country:
Please provide the country for your organization.
Email Address:
REQUIRED
Please provide a valid email address.
Phone Number:
REQUIRED
Please provide a valid telephone number in the format (770) 123-4567.
COPY OF REPORT & INVOICE TO:
COPY TEXT FROM ORIGINAL REPORT & INVOICE FIELDS
Name:
Please provide your full name.
Organization Name:
Please provide the name of your organization.
Address Line 1:
Please provide the first line of the address for your organization.
Address Line 2:
Please provide the second line of the address for your organization.
City:
Please provide the city for your organization.
State/Province:
Please provide the state or province for your organization.
Postal Code:
Please provide the postal code for your organization.
Country:
Please provide the country for your organization.
Email Address:
Please provide a valid email address.
Phone Number:
Please provide a valid telephone number in the format (770) 123-4567.
CASE DETAILS:
Case #:
REQUIRED
Please provide the case number.
Claim #:
REQUIRED FOR 3RD PARTY BILLING
Please provide the claim number.
Insured:
REQUIRED FOR 3RD PARTY BILLING
Please provide the name of the insured.
Policy #:
REQUIRED FOR 3RD PARTY BILLING
Please provide the insurance policy number.
Date of Fire:
REQUIRED
Please provide the date of the fire.
Date Collected:
REQUIRED
Please provide the date of collection.
Collected By:
REQUIRED
Please provide the name of the investigator that collected the evidence.
Transported By:
REQUIRED
Please provide the name of the investigator that transported the evidence.
EVIDENCE DETAILS:
Description and Location Collected:
REQUIRED
01
Please provide the description of item and location where the item was collected.
02
Please provide the description of item and location where the item was collected.
03
Please provide the description of item and location where the item was collected.
04
Please provide the description of item and location where the item was collected.
05
Please provide the description of item and location where the item was collected.
06
Please provide the description of item and location where the item was collected.
07
Please provide the description of item and location where the item was collected.
08
Please provide the description of item and location where the item was collected.
09
Please provide the description of item and location where the item was collected.
10
Please provide the description of item and location where the item was collected.
Examination Requested:
REQUIRED
Please detail the examination requested.
Notes or Special Instructions:
Please provide any notes or special instructions.
Testing Facility:
REQUIRED
Select a testing facility...
Thorsby, Alabama Facility
Lawrenceville, Georgia Facility
Please select a testing facility.
Submit Transmittal
