PROPERTY/EVIDENCE CUSTODY REPORT
Time/Date Obtained:
Name of Person from whom Received:
_________________________________________
OR Location Collected:
_________________________________________
CASE NUMBER:
Department Name:
Address and Telephone number (include zipcode)
Please fill in the address here.
Phone:
Reason Obtained:
Laboratory Exam Requested:
___Evidence
_
__Found
___SafeKeeping
___Recovered
___Yes
___No
Item No:
Quantity
Description of Articles (include model, serial number, etc.)
CHAIN OF CUSTODY
Item No:
Date
Released By
Received By
Purpose of Custody change
Signature
Signature
Printed Name
Printed Name
Signature
Signature
Printed Name
Printed Name
Signature
Signature
Printed Name
Printed Name