Fillable Printable Missing Person Report Form - California
Fillable Printable Missing Person Report Form - California
Missing Person Report Form - California
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE
CJIS 8568
(Orig. 12/1992; Rev. 01/2012)
MISSING PERSON REPORT
Pursuant to Penal Code §13519.07(d)
PAGE 1 of 2
Adult Child
Date and Time of Report Date and Time of Last Contact Report Number
Report Type Runaway
Voluntary
Missing Adult
Parental/Family
Abduction
Dependant
Adult
Unknown
Circumstances
Stranger
Abduction
Suspicious
Circumstances
Catastrophe Lost
Category
(Special Handling)
Prior
Missing
Sexual
Exploitation
Urgent
Case
Abducted During
a Crime
Amber
Alert
At Risk,
Describe:
Missing Person Information
Name (Last, First, Middle)
Sex
Male Female
Race
A - Other Asian
B - Black
C - Chinese
D - Cambodian
F - Filipino
G - Guamanian
H - Hispanic, Latin,
or Mexican
I - American Indian
J - Japanese
K - Korean
L - Laotian
O - Other
P - Pacific Islander
S - Samoan
U - Hawaiian
V - Vietnamese
W - White
X - Unknown
Z - Asian Indian
Alias/Moniker/Nickname DOB/Age
Height Weight Eye Color
Corrective Lenses
Glasses Contacts
Hair Color/Style
Facial Hair Scars/Marks/Tattoos Driver's License/ID Number
Residence Address, City, State, Zip Code
Residence Phone Number Social Security Number
Business Address, City, State, Zip Code
Business Phone Number
CII Number
E-Mail Address
Cell Phone Number
FBI Number Local Reference Number
Social Networking Site(s) and Screen Name(s) Probation/Parole/Social Worker Name & Phone
Clothing Jewelry
Last Known Location/Activity (Description or Address, City, State, Zip Code) Possible Destination (Description or Address, City, State, Zip Code)
Alcohol, Drug, Mental Health, or Medical Condition Known Associates/Lifestyle
Per Penal Code §14206, submit photographs, dental/skeletal x-rays, and fingerprints for entry into the Missing Person System.
Mail to: Department of Justice Missing & Unidentified Person Section, P.O. Box 903387, Sacramento, CA 94203-3870 or E-Mail to: [email protected]
X-rays Available
Dental
Skeletal
Yes No
Yes No
Visible Dental Work
Yes No
If Yes,
Describe:
Dentures:
Upper
Lower
Full
Partial
Braces:
Upper
Lower
Dentist Name, Address, Phone Number
Photo Available
Yes
No
Age in Photo
Fingerprints
Yes
No
Broken Bones/Missing Organs
Yes No
If Yes,
Describe:
Medical Provider Name, Address, Phone Number
Vehicle Info.
Operator
SuspectMissing Person
Other,
Describe:
Registered Owner
SuspectMissing Person
Other,
Describe:
License Number State, Province, Country Registration Expiration
Stolen
Veh. Year Make Model Body Style Color(s) Damage to Vehicle
Suspect Information
Name (Last, First, Middle) Relationship to Missing Person
Sex
Male Female
Race DOB/Age
Alias/Moniker(s)/Screen Name(s) Height Weight Eye Color Hair Color/Style Facial Hair
Address, City, State, Zip Code
Phone Number
E-Mail Address
Scars/Marks/Tattoos Clothing
Reporting Party
Name (Last, First, Middle) Relationship to Missing Person
Sex
Male Female
Race DOB/Age
Address, City, State, Zip Code
Phone Number
E-Mail Address
Reporting Officer ID/Badge # Date
Approving Officer ID/Badge # Date
Investigating Agency Address and Phone Number Forward Copy of Report to: (per PC §14205)
Internally Route to:
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE
CJIS 8568
(Orig. 12/1992; Rev. 01/2012)
MISSING PERSON REPORT
Pursuant to Penal Code §13519.07(d)
PAGE 2 of 2
Missing Person's Name (Last, First, Middle) DOB/Age
Report Number
Narrative
Release of Information
Authorization to release photo, dental, and skeletal x-rays per PC §14206
I am a family member, next-of-kin, or law enforcement official investigating the disappearance of the missing person , and I hereby authorize the release of all dental or skeletal x-rays
and treatment notes, photographs, physical description, and circumstances surrounding the disappearance to assist law enforcement agencies in locating the above named missing
person. This information may be used by the Department of Justice for inclusion in bulletins and posters, which will be distributed throughout California and on the Internet, including
the Attorney General's Web Site at http://oag.ca.gov/ and the FBI's National Dental Image Repository, to assist law enforcement agencies in locating the missing person.
Yes No
Initial
Authorization to release information to the National Missing and Unidentified Person System per PC §14201.3
I am a family member, next-of-kin, or law enforcement official investigating the disappearance of the missing person and I hereby authorize the release of all dental or skeletal x-rays,
photographs, physical description, and circumstances surrounding the disappearance to the National Missing and Unidentified Person System (NamUs) at http://namus.gov/.
Yes No
Initial
Name Signature Date
Relationship to Missing Person Address
Phone Number
Submit photograph(s), dental/skeletal x-rays, and fingerprints to:
California Department of Justice, Missing & Unidentified Persons Section
P.O. Box 903387, Sacramento, CA 94203-3870
