Cyber Crime Unit Submission Form

Tupelo Police Department

Criminal Investigation Division

Cyber Crime Unit Submission Form

Date

Submitting Agency(Required)

Tupelo Police Dept: CID

Outside Agency

Outside Agency Name(Required)

Law Enforcement Agency Name

Case Number(Required)

Your Dept. Case Number:

Lab Number

Cyber Crime Lab Use Only

Offense(Required)

Submitting Officer(Required)

First Last

Officer Phone #(Required)

Victim Name

First Last

Suspect Name

First Last

Authorization(Required)

Search Warrant

Owner Consent

Attach SEARCH WARRANT or OWNER CONSENT FORM(Required)

Drop files here or

Accepted file types: pdf, jpg, gif, png, jpeg, Max. file size: 100 MB.

Special Instructions or Examination Needs

Device Information

Number of Items Being Submitted(Required)

Item (A)

Item (B)

Passcode (A)

Passcode (B)

Serial Number (A)

If Known

Serial Number (B)

If Known

IMEI: (A)

If Known

IMEI: (B)

If Known

Item (C)

Item (D)

Passcode (C)

Passcode (D)

Serial Number (C)

If Known

Serial Number (D)

If Known

IMEI: (C)

If Known

IMEI: (D)

If Known

Item (E)

Item (F)

Passcode (E)

Passcode (F)

Serial Number (E)

If Known

Serial Number (F)

If Known

IMEI: (E)

If Known

IMEI: (F)

If Known

Item (G)

Item (H)

Passcode (G)

Passcode (H)

Serial Number (G)

If Known

Serial Number (H)

If Known

IMEI: (G)

IMEI: (H)

Item (I)

Item (J)

Passcode (I)

Passcode (J)

Serial Number (I)

If Known

Serial Number (J)

If Known

IMEI: (I)

IMEI: (J)

Item (K)

Item (L)

Passcode (K)

Passcode (L)

Serial Number (K)

If Known

Serial Number (L)

If Known

IMEI: (K)

IMEI: (L)