STATE OF VERMONT



|STATE OF VERMONT |[pic] |TEL: 802-244-8788 |

|DEPARTMENT OF PUBLIC SAFETY | |FAX: 802-241-5557 |

|VERMONT FORENSIC LABORATORY | |E-MAIL: DPS.ForensicLab@ |

|P.O. BOX 47 | | |

|WATERBURY, VERMONT 05676-0047 | | |

|NOTICE – READ THESE INSTRUCTIONS FIRST |

|Submit one request form for each separate case number. |

|Four images per sheet will automatically be forwarded for major cases only, as indicated below in the Description of Incident section of this form. Nine |

|Images per index sheet will be the normal index configuration. |

|Please review image sheets before making subsequent request for services. |

|REQUEST FOR PHOTOGRAPHIC SERVICES |

|Case #: |      |Agency: |      |

|Requested by: |      |Contact Number: |      |

|Date Sent: |      |Date Required: | |

|Description of |Arson |

|Incident: |10 –50 Fatal |

| |BCI |

|Submission |Requests |

|Mark (x) material |Mark (x) size requested |

| Item Quantity | Request prints from previous submittal |

|CD Disk(s) ________ |Contact Sheet(s) |

|Video Tape ________ |9-Up 4-Up |

|Other (See Special Instructions) ________ |CD Disk(s) |

| |Video Tape Still Images Video Dubbing |

| |Custom - Fill in Special Instructions area or call the Imaging Section at |

| |802-241-5295. |

|Special Instructions/ Reason Photographs Requested: Investigative |

|Major Case Prep. |

|Court– Date:________ |

| |

|Number of Sets Required: _________ |

|LABORATORY USE ONLY |

|Database Tracking # |Date service completed |

|Contact Sheets | |9-Up | |

| | | | |

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