Fillable Va Form 21-1775 - Statement Of Disappearance (Page 5 of 6) in pdf

Va Form 21-1775 - Statement Of Disappearance Page 5

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52. WHAT WERE THE MISSING PERSON'S HOBBIES, HABITS, AND INTERESTS?

53. DID THE MISSING PERSON TAKE ANY LONG TRIPS OR VACATIONS?

YES

(If "YES", with whom and where did the missing person usually travel?)

54. DID THE MISSING PERSON USUALLY KEEP SOMEONE INFORMED OF HIS/HER WHEREABOUTS?

(If "YES", who usually knew?)

YES

(Explain fully)

55. INDICATE WHETHER THE MISSING PERSON TALKED ABOUT ANY PARTICULAR LOCATIONS, STATES OR COUNTRIES

56. DID THE MISSING PERSON EVER GO AWAY BEFORE FROM HIS HOME OR FAMILY WITHOUT EXPLANATION?

(If "YES", explain fully)

YES

IV - INFORMATION REGARDING MISSING PERSON'S DISAPPEARANCE

INSTRUCTIONS: Give exact dates if possible. Attach copy of reports of police or other agencies, newspaper items, letters and notes or other evidence relating to the

disappearance. Also attach a copy of any court proceedings declaring the missing person to be dead. THIS EVIDENCE WILL BE RETURNED TO YOU.

57. DATE DISAPPEARED

58. DATE LAST REPORTED SEEN BY ANYONE

59. PLACE LAST SEEN BY ANYONE

60. STATE CIRCUMSTANCES OF THE OCCASION WHEN THE MISSING PERSON WAS LAST SEEN AND THE NAME AND ADDRESS OF THE PERSON WHO LAST

SAW HIM/HER

61. DID THE MISSING PERSON ADVISE ANYONE OF AN INTENTION TO TRAVEL?

(If "YES", what was the planned destination?)

YES

62. GIVE NAMES AND ADDRESSES OF ANY PERSONS WHO WERE FAMILIAR WITH THE MISSING PERSON'S PLANS

63. WERE YOU TOLD THE REASON FOR LEAVING OR DO YOU HAVE ANY KNOWLEDGE OR OPINION AS TO THE MISSING PERSON'S REASON FOR

LEAVING?