Request For Acic "Hot File" Information Form (Page 2 of 3) in pdf

Request for ACIC “Hot File” Information

Requestor Information:

Requestor’s Name: _______________________________________________________________________

Date of Birth: ___________________________Driver License Number ______________________DL State: ____________

Address: _____________________________________________________________________________________________

City: __________________________________________________________________ State: ________Zip: _____________

Phone Number: (home)___________________________________ (business) ______________________________________

Please complete the appropriate section below:

Property

Type of Property (example: TV, computer, stereo, etc.)__________________________________________

Brand___________________________________________

Serial Number_______________________________ Model Name or Number______________________________________

Current Owner ________________________________________________________________________________________

Location of Property____________________________________________________________________________________

Additional Information __________________________________________________________________________________

Vehicle

VIN______________________________________ License Plate Number__________________ License Plate State________

License Plate Year_____________ License Plate Type_______________ Vehicle Year___________________

Vehicle Make (example: Chevrolet, Ford, etc.) ________________________________________________________________

Vehicle Model (example: Camaro, Taurus, etc.) __________________________________________

Current Owner _________________________________________________________________________________________

Location of Property_____________________________________________________________________________________

Additional Information __________________________________________________________________________________

Gun

Brand _________________________________________Serial Number ___________________________________________

Model ____________________________________________________Caliber or Gauge _____________________

Current Owner _________________________________________________________________________________

Location of Property_____________________________________________________________________________

Additional Information ___________________________________________________________________________

Arkansas Crime Information Center

7-18-00

Request For Acic "Hot File" Information Form Page 2