Working together to help keep our children safe

Parent or Legal Guardian Case Registration

To be filled out by non law enforcement agencies only - Please be sure to notify investigating officer of your intent to place your case on line, as we will be verifying content with them.

Please provide the following information (items in red are mandatory):

This is a:

New Registration

Update on case currently online

Police Department Handling Case:(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone Number:(Required)

E-Mail Address:(Required)

Web Address (If Applicable):(Required)

Police File Number:(Required)

Missing Person Information

Name(Required)

First Last

Date of birth(Required)

Date of disappearance(Required)

Race(Required)

Ethnic origin:(Required)

Gender(Required)

Male

Female

Eye Color(Required)

Hair Color(Required)

Uses which hand:(Required)

Glasses(Required)

Yes

No Choice

Contact lenses(Required)

Yes

Birthmarks or other distinguishing characteristics(Required)

Medical History:(Required)

Dental History:(Required)

Details surrounding last known sighting or when last seen:(Required)

Medical Health Number:(Required)

Social Insurance Number/or Social Security Number:(Required)

Drivers License Number:(Required)

Suspected to be in company of:

Name(Required)

First Last

Relationship to missing person:(Required)

Description of possible abductor:(Required)

Name of Person Submitting this Case:

1. Name and Relationship to Missing Person:(Required)

Day Phone Number:(Required)

Evening Phone Number:(Required)

E-Mail Address:(Required)

2. Name and Relationship to Missing Person:(Required)

Day Telephone Number:(Required)

Evening Telephone Number:(Required)

E-Mail Address:(Required)

Other Pertinent Information:

Upload picture

Max. file size: 15 MB.

Working together to help keep our children safe

Parent or Legal Guardian Case Registration

Missing Person Information

Suspected to be in company of:

Name of Person Submitting this Case:

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