New York State Intelligence Center Main:
FAX:
Latham, New York 12110 Toll-free:
REQUEST FOR INFORMATION FORM
DATE & TIME OF REQUEST MEMBER/ANALYST ASSIGNED
RICS Control #: Rank:
Received/Entered By: Last Name:
Date: Time: Tax / SS#:
REQUESTOR'S INFORMATION
Agency Name and Investigation
NY03030C9 Command/Unit: Child Exploit T/F Sex Trafficking
ORI: Type:
Workplace (Full Address): 26 Federal Plaza, New York, NY 10278
Last Name First Name: Rank/Title: Detective
Tax # NYPD Only: SSN: Date of Appointment: 08/30/1993
Office #: Fax #: Pager/Cell#: Pin:
31E-NY-
TZS/Pct. Of Occ.: Compl#: Case#: Conferred w/ Requestor Date: Time:
302870
Supervisor's Rank/Full Name: LT Phone Number: -
SUBJECT INFORM TION
Last Name: First Name: Middle: Aliases:
DOB: Age: Sex Race: POB: Gang Name:
Bldg# Street: Apt: City:
State: Tel# SSN#
Code:
Driver License#: State/Country: Arrest:
FBI#: NYSID/4: Other State SID#:
BUSINESS LOCATION & FINANCIAL INFORMATION
Business
Bldg: Street:
Name:
City State: Zip Code Tel#:
Last Name: First Name: (Circle One) Owner/Mgr/Employee
Tax ID/4: Financial Institution: Account Type:
VEHICLE INFORMATION
Plate #: State/Country: MA Year: 19 Make: CHEV Model:
No. Doors/Body Style: Color: Gray VIN#:
REMARKS
What have you (Requestor) done?
What needs to be done by NYSIC personnel?
I am requesting the assistance of the NYSP regarding a CIAS check as well as NYSP , LPR's,.
EMAIL Request to NYSIC: ciu6i)nvsic.nv.eov OR
EFTA00038391
to verify that your FAX was received!)
EFTA00038392