Licensed by the Texas Department of Public Safety Private Security Bureau #A06859


Company Name
Mailing Address
City, State, ZIP
Requestor
Telephone
Fax
Email Address
Request Date
Date of Loss
Amount of Loss
Case Ref/Insured
Case Ref/Claim #
 

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Subject's Name
Spouse
Last Known Address
City, State, Zip
Telephone
DOB    
DL# DL State
Race Sex
Height Weight Hair Other
Last Known Employer
Occupation/Title
Employer Address
Employer Telephone
Veh. Make/Year Tag #
VIN State
Owner Name
Owner Address
Insurance
Nature of Injury
Other Information:
Special Instructions/Comments:

* Please send police reports or any other documentation available via the contact info at the top of the page.


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Contact Information

PO Box 116138
Carrollton TX 75011
972-394-3538
fax - 972-307-1579

Association
Memberships


Member
Texas Association of
Licensed Investigators
since 1993

 

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