San Bernardino |Private Investigator   

 

SERVICE  AREA

San Bernardino|  Los Angeles|  Diamond Bar   Orange County|
Santa Ana | Anaheim Hills| Riverside| Temecula| San Diego| Ventura

AVAILABLE 24 HOURS, WEEKDAYS, WEEKENDS & HOLIDAYS 

909-278-0059 Local or 1(877) 239-9765 TOLL FREE

Surveillance Activity Request

Surveillance and Activity Request


We have the ability to deploy GPS tracking systems for vehicles for fleet monitoring.
Firm
Attention
Address
Date
City, State, Zip
Court
Telephone
Case No
Ext./Direct Line
Case Title
Your Fax No.
Claim/File No.
Your E-mail
Date of Loss


PLEASE NOTE ANY SPECIFIC SERVICE REQUIREMENTS
Please check the services required:



Date
Completion Deadline
Trial or Hearing Date
Subject
Social Security No.
Address
City
State
Zip
Phone
If two crews are needed (i.e., rural cases), is permission granted to proceed?


Physical Description
Date of Birth
Sex
Race
Marital Status
Spouse’s Name
Subject’s Vehicles
Alleged Injury
Physical Restrictions
Claim #
Date of Loss
Insured
Type of Claim
Previous Surveillance Performed?


(If “Yes,” attach report.)
Does the claimant have a history of violent behavior?


If “Yes,” two crews are necessary
What is the purpose of the investigation?
Special Instructions:
Are there specific days for the surveillance to be conducted?


If “Yes,” What days?
Restrictions: Day or $ Limit
Client
Company
Address
City
State
Zip
Phone #
FAX
E-Mail




Is there a secondary contact for this case?


(If “Yes,” please fill in the form below:)
Client
Phone #
FAX
E-Mail




Are you a full-time client?


Referred by
 

San Bernardino (909) 620-0139 ** Riverside (951) 239-0583 ** Los Angeles 1(877) 239-9765
Websiteforge ecommerce web site design