Protective Orders - Data Entry Form For Texas Crime Information Center (Tcic) - Texas Department Of Public Safety
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1
2PROTECTIVE ORDERS
Data Entry Form for
TEXAS CRIME INFORMATION CENTER (TCIC)
The intent of this form is to aid court clerks with the collecting and providing to local law enforcement
agencies pertinent information regarding protective orders for the purpose of entry into TCIC.
To be filled out by Criminal Justice/Law Enforcement Official:
ORI: _______________
PROTECTIVE ORDER: ________ EMERGENCY PROTECTIVE ORDER: ________
(check one)
OCA: __________ PROTECTIVE ORDER NO: ______________ COURT IDENTIFIER: ___________________________
ISSUE DATE: ____________ DATE OF EXPIRATION: _________________ DATE OF DISMISSAL: ________________
***RESPONDENT INFORMATION***
Items in ALL UPPERCASE LETTERS must be answered to allow entry into TCIC.
NAME OF RESPONDENT: ____________________________________________________
SEX:
M
F
(circle one)
RACE:
) Indian Asian Black White Unknown
Ethnicity:
)
Hispanic
Non-Hispanic
Unknown
(circle one
(circle one
Place of Birth: (State
__________________________ DATE OF BIRTH: ___________ HEIGHT: ________ WEIGHT: __
)
Skin:
Albino Black Dark Dk Brown Fair Light Lt Brown Medium Med Brown Olive Ruddy Sallow Yellow Unknown
(circle one)
EYE COLOR:
Black
Blue
Brown
Gray
Green
Hazel
Maroon
Pink
Multi-Colored
Unknown
(circle one)
HAIR COLOR:
Black
Blond
Brown
Gray
Red
White
Sandy
Bald
Unknown
(circle one)
Scars, Marks and/or Tattoos (please describe in detail): __________________________________________________________
_________________________________________________________________________________________________________
RELATIONSHIP TO PROTECTED PERSON: ________________________________________________________________
(PLEASE INCLUDE THE FOLLOWING NUMERIC IDENTIFIERS, IF AVAILABLE):
Texas I.D. No: _________________ Misc. I.D. No: _______________________ Social Security No: ______________________
Driver’s License No: _________________ Driver’s License State: _______________ Date of Expiration: _________________
Respondent’s Adress:
Street: ________________________ City: ___________ State: __________ Zip: _______ COUNTY: _______________
Respondent’s Vehicle Information:
License Plate No: _____________ L.P. State:__________ L.P. Year of Expiration: ________ L.P. Type: ____________
Vehicle I.D. #: __________________ Year: _____ Make: _______ Model: ________ Style: ________ Color: _________
To be filled out by Criminal Justice/Law Enforcement Official
:
SID #: __________________ FBI #: __________________ FPC: __________________________
MNU: _______________
TEXAS DEPARTMENT OF PUBLIC SAFETY (JANUARY 2096)
Continued on Reverse Side
S:\FormsLib\Civil Bureau\Civ Fam Intake & Customer Svc\Civintake\Protective Order TCIC Data Entry Form
Created 2/7/96
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