Full Name of Requestor(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Requestors Relationship to the Victim(Required)

Full Name of Victim(Required)

First Last

Did the Victim live in Harris County Precinct 3?(Required)

Yes

No

Please upload a high resolution picture of the victim only.

Max. file size: 50 MB.

Investigative Agency

Which agency is investigating this case?

Case #

Date of Incident

Case Status(Required)

Solved

Unsolved

Suspect(Required)

Known

Unknown

Suspect Name

First Last

Email

This field is for validation purposes and should be left unchanged.

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