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Assign/Request Case

Complete the form below to get started working with a private investigator on your case.

Case Assignment Form

Name

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Claim#

Date

Services

Surveillance

Skip Trace / Location

Activities Check

Statement / Interview

Background Check

Liability

Employment Check

Other

Subject Information

Name

First Last

Phone

Address

Street Address City State

SSN

City of Birth

State of Birth

Date of Birth

Driver’s License Number

Description of Subject

Attach Photo

Max. file size: 50 MB.

Hair

Height

Weight

Eye Color

Spouse Name

Dependants

Vehicle Make

Vehicle Model

Vehicle Color

Vehicle Tag Number

Occupation

Employer

Alleged Injury

Date of Loss

Insured / Address

Treatment

Restrictions

Prior Investigation / Surveillance

Yes

(if Yes, please explain)

Explain

Special Instructions

Client Info

Authorized Limits:(Required)

(Includes Expenses)

Total Number of Days(Required)

Client Name(Required)

First Last

Email Address(Required)

Main Phone Number(Required)

Company Name

Fax/Other

Address

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Home
Investigations
Insurance Services
Attorney Services
Assign/Request a Case
Contact

Phone: 646-542-0502
24 Hour Rapid Response: 718-702-8975

Hours:
Monday – Friday: 9 AM – 5 PM

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Serving the Tri-State Area
(New York, New Jersey, & Connecticut)

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