Form Center

Who Is Missing? (Name of Person Missing and Name of at Least One Contact Field is Required.) Please answer as many questions as possible.

2. Who Is Missing?

4. Last Name*

5. First Name*

6. Initial

8. Sex

   1. Male
   2. Female

9. If Female/Maiden Name

10. Age of Missing Individual

11. DOB
    DOB

13. Race

14. Social Security #/Other

15. Birth City/State

16. Birth Hospital

18. Address

19. City

20. State

21. Zip

23. County

24. Country

25. Live Inside City Limits

    1. Yes
    2. No

26. Religious Preference

28. Phone (H)

29. Phone (W)

30. Phone (Cell)

32. Education: Level Completed

33. Elem/Second (0-12):

34. College

35. Degree Earned:

39. Marital Info

41. Marital Status

    1. Married
    2. Never Married
    3. Widowed
    4. Divorced
    5. Seperated
    6. Unknown

42. Wedding Date
    Wedding Date

43. Spouse

    1. Living
    2. Deceased
    3. Unknown

45. Spouse Last Name

46. Spouse First Name

47. Maiden/Birth Name

49. Father Last Name

50. Father First Name

51. Middle

53. Mother Last Name

54. Mother First Name

55. Middle

59. Next of Kin

60. Last Name

61. First Name

62. Middle

64. Address

65. City

66. State

67. Zip

69. Relationship

    1. Wife
    2. Husband
    3. Father
    4. Mother
    5. Brother
    6. Sister
    7. Son
    8. Daughter
    9. Employer
    10. Friend
    11. Other

70. Phone (H)

71. Phone (W)

72. Phone (Cell)

74. Permanent Contact

    Please place name and contact info here.

78. Contact 1

79. Last Name*

80. First Name*

81. Middle

83. Address

84. City

85. State

86. Zip

88. Relationship

    1. Wife
    2. Husband
    3. Father
    4. Mother
    5. Brother
    6. Sister
    7. Son
    8. Daughter
    9. Employer
    10. Friend
    11. Other

89. Phone (H)

90. Phone (W)

91. Phone (Cell)

93. Email

94. Date of Initial Contact
    Date of Initial Contact

95. Type of Initial Contact

99. Contact 2

100. Last Name

101. First Name

102. Middle

104. Address

105. City

106. State

107. Zip

109. Relationship

     1. Wife
     2. Husband
     3. Father
     4. Mother
     5. Brother
     6. Sister
     7. Son
     8. Daughter
     9. Employer
     10. Friend
     11. Other

110. Phone (H)

111. Phone (W)

112. Phone (Cell)

114. Email

115. Date of Initial Contact
     Date of Initial Contact

116. Type of Initial Contact

120. Contact 3

121. Last Name

122. First Name

123. Middle

125. Address

126. City

127. State

128. Zip

130. Relationship

     1. Wife
     2. Husband
     3. Father
     4. Mother
     5. Brother
     6. Sister
     7. Son
     8. Daughter
     9. Employer
     10. Other

131. Phone (H)

132. Phone (W)

133. Phone (Cell)

135. Email

136. Date of Initial Contact
     Date of Initial Contact

137. Type of Initial Contact

141. Hair Info of Missing Person

142. Hair Color

     1. Auburn
     2. Blond
     3. Brown
     4. Black
     5. Grey
     6. Red
     7. Salt and Pepper
     8. White

143. Hair Length

     1. Bald
     2. Shaved
     3. Short < 3'
     4. Medium
     5. Male Pattern Baldness
     6. Long

144. Hair Accessary

     1. Extensions
     2. Hair Piece
     3. Hair Transplant
     4. Wig
     5. N/A

146. Hair Description

     1. Curly
     2. Wavy
     3. Straight
     4. N/A

147. Facial Hair Type

     1. Clean Shaven
     2. Beard and Mustache
     3. Goatee
     4. Sideburns
     5. Moustache
     6. Beard
     7. Stubble
     8. Lower Lip
     9. N/A

148. Facial Hair Color

     1. Blonde
     2. Black
     3. Red
     4. White
     5. Brown
     6. Grey
     7. Salt and Pepper
     8. N/A

152. Eye Info of Missing Person

153. Eye Color

     1. Blue
     2. Brown
     3. Green
     4. Hazel
     5. Grey
     6. Black

154. Color/Description

156. Optical Lens

     1. Contacts
     2. Glasses
     3. Implants
     4. None

157. Desc.

158. Eye Status

     1. Missing R
     2. Missing L
     3. Glass R
     4. Glass L
     5. Cataract
     6. N/A

162. Nail Info of Missing Person

164. Fingernail Type

     1. Natural
     2. Artificial
     3. Unknown

165. Fingernail Length

     1. Extremely Long
     2. Long
     3. Medium
     4. Short

166. Fingernail Color/Description

167. Fingernail Characteristics

     1. Bitten
     2. Decorated
     3. Misshapen
     4. Yellowed/Fungus
     5. N/A

169. Toenail Color

170. Toenail Description

171. Toenail Characteristics

     1. Bitten
     2. Decorated
     3. Misshapen
     4. Yellowed/Fungus
     5. N/A

175. Body Piercings

176. Piercings

     1. Yes
     2. No

177. Photos

     1. Yes
     2. No

178. Photo Location

180. Location #1

181. Side #1

182. Description #1

183. Photo #1

185. Location #2

186. Side #2

187. Description #2

188. Photo #2

190. Location #3

191. Side #3

192. Description #3

193. Photo #3

197. Tattoo(s)

198. Tatoo(s)

     1. Yes
     2. No

199. Photos

     1. Yes
     2. No

200. Photo Location

202. Location #1

203. Side #1

204. AM Tat Description #1

206. Location #2

207. Side #2

208. AM Tat Description #2

210. Location #3

211. Side #3

212. AM Tat Description #3

216. Dental Info

217. Dentist Name

218. Info Listed

     1. Yes
     2. Unknown

219. Phone

221. Dentist Address

222. State

223. Zip

225. Dental

     1. Dental Work
     2. Dentures
     3. Both
     4. Braces
     5. Partials
     6. Tooth Jewelry

226. Additional Dental Information/2nd Dentist

230. Physician Info

231. Physician Name

232. Practice Name

233. Physician Type

235. Address

236. State

237. Zip

238. Phone

240. Email

241. Seen For

242. Records Requested

     1. Yes
     2. No

243. Records Obtained

     1. Yes
     2. No

247. Medical Radiographics

     1. Yes
     2. No
     3. Unknown

248. Physician(s)

249. Address

251. Medical Radiographs Location

252. Potential Type of Radiographs- and Dates taken If Known

256. Old Fractures

     1. Yes
     2. No

257. Description

259. Objects in Body

     1. Pacemaker
     2. Bullets
     3. Implants
     4. Needles
     5. Shrapnel
     6. Other

260. List other objects here.

261. Surgery

     1. Gall Bladder
     2. Appendectomy
     3. Tracheotomy
     4. Laparotomy
     5. Mastectomy
     6. Reconstructive
     7. Open Heart
     8. Other

262. List other surgeries here.

266. Diabetic

     1. Yes
     2. No
     3. Unknown

267. If Female / Pregnancy in the last 12 months?

     1. Yes
     2. No
     3. Unknown

271. Unique Characteristics

     1. Yes
     2. No

272. Description of: Scars, Operations, Birthmarks, Burns, Missing Organs, Amputations, Other Special Characteristics

276. Prosthetic(s)

     1. Yes
     2. No

277. Prosthetic Location/Description

281. Last Seen

282. Group Status

     1. Alone
     2. Group

283. Group Type

     Family, Church Group, Sports, Military

284. Family/Grp Name

     If Family Group, list names here.

286. Last seen with

288. Last location victim was seen

292. Military Service

     1. Yes
     2. No
     3. Unknown

293. Military DNA Taken

     1. Yes
     2. No
     3. Unknown

294. Country

295. Service #:

297. Approximate Service Date

298. Military Branch

302. Ever Fingerprinted:

     1. Yes
     2. No

303. Immigration Status

304. Resident Alien Card (Green Card)

     1. Yes
     2. No

306. Finger/Foot Printed

     1. Fingerprints
     2. Footprints

307. Ever been arrested

308. Arrested by

310. Print Located

314. Usual Occupation

315. Type of Business

317. Employer

318. Phone

320. Employer Address

     Please list last employer if retired. Additional employers enter in additinal date section.

324. List memberships, clubs, fraternities, etc.

328. Additional data

Leave This Blank:


330. 1. Receive an email copy of this form.
331. Email address

     This field is not part of the form submission.

332. Submit Submit and Print

* indicates a required field