Coast Guard Investigative Service Evidence Custody Form

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U.S. Depar t m ent of
COAST GUARD INVESTIGATIVE SERVICE
Homeland Security
U.S. Coast Guard
EVIDENCE CUSTODY FORM
CG - 6000 ( 6-04)
1. Receiving Office
2. Case Control Number (CCN)
3. Evidence Log Type and Number
4. Case Title/Subject
6. Address (include ZIP)
5. Name/ Grade / Title of Person From Whom Seized/Received
Owner
Other
7. Work Phone
8. Home Phone
9. Location Where Property Seized/Received
10. Reason Obtained
11. Time/Date Seized/Received
12. Seized/Received By (Printed Name)
Other
Found
Impounded
Evidence
13. Item
14. Quantity
15. Disposal Action
16. Description of Article/Make, Model, Serial Number, Identifying Marks,
Condition, Value, Weight, and Evidence Tag Number
17. Name and Signature of Witness
18. Name and Signature of Evidence Custodian
19. CHAIN OF CUSTODY
Items
Date/Time
Released By
Received By
Purpose
Name
Name
Organization
Organization
Signature
Signature
Name
Name
Organization
Organization
Signature
Signature
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