Fillable FORENSIC LABORATORY EXAMINATION REQUEST (Washington Headquarters Services)

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FORENSIC LABORATORY EXAMINATION REQUEST (Washington Headquarters Services)

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The FORENSIC LABORATORY EXAMINATION REQUEST (Washington Headquarters Services) form is 2 pages long and contains:

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  • 10 check-boxes
  • 30 other fields

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Page 1 of 2
PREVIOUS EDITION IS OBSOLETE
DD FORM 2922, APRIL 2021
FORENSIC LABORATORY EXAMINATION REQUEST
1. TO:
USACIL
4930 N. 31st Street
Forest Park,GA
30297-5205
FXL
AGENCY DFE
Have any of the items ever been
submitted to any other laboratory?
(Specify)
2. FROM:
3. RETURN EVIDENCE TO:
4. EXAM PRIORITY
ROUTINE
EXPEDITE
TRIAL DATE:
Subject in pre-trial confinement
Subject Pending
PCS/Separation Date:
Other (Specify in block 13)
5. LAB USE ONLY
a. LAB CASE #
b. RECEIVED DATE
6. SUBMITTING AGENCY/UNIT CASE NUMBER 7. TYPE OF OFFENSE
8. PREVIOUS EVIDENCE SUBMITTED OR PRE-SUBMISSION LAB CASE NUMBER
DATE: MAIL METHOD: LAB CASE #:
9. SUSPECT(S) [Last, first and middle names(s)] 10. VICTIM(S) [Last, first and middle name(s)]
11. BRIEF DESCRIPTION (SYNOPSIS) OF CASE FACTS THAT MIGHT ASSIST THE LABORATORY IN EXAMINING OR EVALUATING THE EVIDENCE OR ADDITIONAL
DOCUMENTATION ATTACHED (e.g., Summary of investigation, crime scene sketches/photographs, statements, SA kit paperwork)
12. EVIDENCE SUBMITTED
a. EXHIBIT
b. DESCRIPTION OF EXHIBIT WITH ALTERNATE ID (ECM ITEM NUMBER)
Page 2 of 2
PREVIOUS EDITION IS OBSOLETE
DD FORM 2922, APRIL 2021
12. EVIDENCE SUBMITTED (Continued)
a. EXHIBIT
b. DESCRIPTION OF EXHIBIT
13. EXAMINATION(S) REQUESTED (Briefly furnish any information or instructions that might assist the laboratory in examining the evidence)
14.a. INVESTIGATOR AND ALTERNATE POC (Typed or printed) (Mandatory information)
b. TELEPHONE (Primary/Alt):
c. DSN (Primary/Alt):
d. E-Mail:
15.a. DATE b. TYPE/PRINTED NAME OF REQUESTOR
c. SIGNATURE
d. TELEPHONE (Primary/Alt):
e. DSN (Primary/Alt):
f. E-Mail:
16. LAB USE ONLY
LAB CASE #
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FORENSIC LABORATORY EXAMINATION REQUEST (Washington Headquarters Services)

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Completed 24 May 2021

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