Houston Forensic Science Center
Evidence Submission Form
Client Services & Case Management Division
Evidence Submission Form
Issued By: Section Manager
Uncontrolled When Printed
Document ID: 20190
Issue Date: January 5, 2018
Page 1 of 1
C. Associated Individuals: Must indicate Suspect (S), Complainant (C), Involved Party (I), or Other (O). A State ID # or FBI ID # is required for latent print
requests, if applicable. *Please use supplemental sheet for additional individuals
Last Name
First Name
MI
Date of Birth
Gender
Race
S/C/I/O
SID/FBI #
D. Evidence Submitted: Must include Manufacturer, Model and Serial/IMEI number for any applicable items. Warrants or Consent to Search forms must be
provided with the submission of digital evidence unless the owner is deceased. *Please use supplemental sheet for additional evidence items.
Detailed Description of Item(s)
From Whom/Where Recovered
E. Analysis Requested: Provide a detailed statement regarding the type(s) of analysis needed.
HFSC may conduct additional analysis not requested here if deemed useful/necessary.
G. Submitter Information: Signature and Date should be completed at the time of submission.
Submitter Name:
Agency:
Email:
Phone:
Signature:
Date:
HOUSTON FORENSIC SCIENCE CENTER USE ONLY
Received By:
Date:
Time:
B. Requestor Information
First Name: Last Name:
Agency:
Address:
City: County:
State: Zip:
Office Phone: Cell Phone:
Email:
A. Case / Offense Information
Agency:
Case Number:
Offense Type:
Offense Date:
Offense Location:
City: County:
State: Zip:
F. Digital Evidence: Draw unlock pattern using
arrows to indicate direction
Item #:
Password:
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