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pdfLAW ENFORCEMENT SENSITIVE
U.S. Department of Justice
Federal Bureau of Investigation
FD-676 (Rev. 6-3-2010)
OMB No. 1110-0011
CASE SUBMISSION FORM
Federal Bureau of Investigation
Critical Incident Response Group
National Center for the Analysis of Violent Crime
Violent Criminal Apprehension Program
Phone: (703) 632-4254 / Toll Free: (800) 634-4097 / Fax: (703) 632-4239
Email: [email protected]
Mailing Address: FBI Academy, CIRG-ViCAP, Quantico, VA 22135
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ViCAP Case Submission Form
National Center for the Analysis of Violent Crime (NCAVC)
The NCAVC is a law enforcement-oriented behavioral and data analysis center which provides behaviorally-based
operational support to federal, state, local, tribal, and foreign law enforcement, intelligence and security agencies.
Violent Criminal Apprehension Program (ViCAP)
Established in 1985, ViCAP serves as the national repository for violent crimes. It is a web-based application
available to law enforcement agencies nationwide through connectivity of the Law Enforcement Online (LEO)
network. ViCAP Web enables law enforcement agencies to enter and analyze their own violent crime information
on a local level, and facilitates the identification of similar cases on a regional, state, and national basis.
Submission Criteria
The ViCAP Web National Crime Database is designed to collect information regarding the following types of
crimes whether or not the offender has been arrested and/or identified:
Homicides and attempted homicides, especially those that (a) involve an abduction, (b) are apparently
random, motiveless, or sexually oriented, or (c) are known or suspected to be part of a series.
♦ Sexual assaults, especially those that (a) were committed by a stranger or (b) are known or suspected to be
part of a series.
♦ Missing persons, where the circumstances indicate a strong possibility of foul play and the victim is still
missing.
♦ Unidentified human remains, where the manner of death is known or suspected to be homicide.
♦
If questions arise regarding whether a case meets the listed criteria, please contact FBI ViCAP for guidance.
Electronic Submission
Cases received in hard copy form will be entered into the ViCAP Web National Crime Database by FBI ViCAP
personnel. However, law enforcement agencies have the option of entering their cases directly, via Law
Enforcement Online (LEO). Access to ViCAP Web also allows agencies to conduct simple and complex searches
for cases nationwide. For information on how to gain access to ViCAP Web, contact FBI ViCAP and request the
analyst assigned to your state.
Instructions
♦
♦
Follow directions associated with each question, such as “check all that apply” and “describe below.”
If in doubt about how to respond to a given item, be guided by your experience and good judgment. For
additional assistance, contact FBI ViCAP and request the analyst assigned to your state.
♦ If your incident has multiple victims or offenders, copy the appropriate sections of this form and provide
separate information for each individual.
♦ If your case includes details that you believe are important but have not been covered by the ViCAP Case
Submission Form, please include them in the narrative section (question 101).
♦ If at any point you are unable to fit information into the form due to space restrictions, be sure to add it in
the table for supplemental information located at the end of this booklet.
♦ If you wish to provide supplemental or revised information for a case previously submitted to FBI ViCAP,
please contact the analyst assigned to your state directly, via phone or email. Note that you can also
update/modify your own cases via ViCAP Web.
♦ If you are interested in obtaining interview, investigative, or media strategies, or a behavioral
assessment/profile on this case, please contact the nearest FBI Field Office and ask to speak to the NCAVC
Coordinator. This individual will provide information and guidance in this area.
LAW ENFORCEMENT SENSITIVE
ViCAP Case Submission Form
Table of Contents
Case Administration........................................................................................................................ 1
Victim Identity ................................................................................................................................ 4
Victim Physical Attributes.............................................................................................................. 5
Victimology .................................................................................................................................... 8
Offender Identity........................................................................................................................... 10
Offender Physical Attributes......................................................................................................... 11
Offender Lifestyle......................................................................................................................... 14
Offender Timeline......................................................................................................................... 16
Offender Sexual History/Preferences ........................................................................................... 17
Approach to Victim....................................................................................................................... 18
Dates and Locations...................................................................................................................... 20
Crime Scene .................................................................................................................................. 22
Victim Clothing, Property............................................................................................................. 26
Victim Trauma .............................................................................................................................. 27
Sexual Activity.............................................................................................................................. 30
Weapon ......................................................................................................................................... 34
Vehicle .......................................................................................................................................... 35
Narrative ....................................................................................................................................... 37
Addendum: Additional Investigative Information........................................................................ 38
Attachments .................................................................................................................................. 39
Supplemental Information ............................................................................................................ 39
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Case Administration
Date Form Completed: __________________________________
Case Sharing
1. In addition to your case being viewed by FBI ViCAP, do you authorize your case to be viewed by all
other ViCAP Web users?
Yes
No
NOTE: If you enter holdback information for question 103, the entire case will automatically be withheld from viewing by any ViCAP Web
users outside of your agency, your hub agency (if applicable), and FBI ViCAP.
Case Status
2. Investigating Agency's Case Status (select one):
Closed
By Arrest
By Exceptional Circumstances
Other (describe) _____________________
Open
Active
Inactive/Suspended
Case Status Date: ______________________
Case Closure Date: _____________________
Investigating Agency
3. Investigating Agency
Agency Name: ___________________________________________________________________
Street Address: ___________________________________________________________________
City: ______________________________ County: _____________________________________
State/Province: _____________
Zip Code: _________________ Country: _________________
Phone Number: ___________________________________________________________________
4. Investigating Agency's ORI Number: ____________________________________________________
Case Numbers
5a. Investigating Agency's Case Number: ___________________________________________________
5b. State Agency's Case Number (if applicable): _____________________________________________
Investigator
6. Name and Contact Information for Primary Investigator:
Title/Rank: _______________________
Phone Number: __________________________
Full Name: ________________________
Email Address: __________________________
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Person Completing Form
7. Name and Contact Information for Person Completing Form (if different from question 6):
Title/Rank: ______________________________________________________________________
Full Name: ______________________________________________________________________
Phone Number: ___________________________________________________________________
Agency Name: ___________________________________________________________________
Street Address: ___________________________________________________________________
City: _________________________________ County: __________________________________
State/Province: ________________ Zip Code: ________________ Country: ________________
Forensic/Physical Evidence
8. Indicate all forensic/physical evidence items pertaining to this case that may be suitable for
comparison:
DNA from Offender
Available
Analyzed
Submitted to LDIS
Submitted to SDIS
Submitted to NDIS
Offender's Prints
Available
Submitted to state repository and processed
successfully
Submitted to IAFIS and processed
successfully
Insufficient quality for processing
DNA from Victim
Available
Analyzed
Submitted to LDIS
Submitted to SDIS
Submitted to NDIS
Victim's Prints
Available
Submitted to state repository and processed
successfully
Submitted to IAFIS and processed
successfully
Insufficient quality for processing
Latent Prints
Available
Submitted to state repository and processed
successfully
Submitted to IAFIS and processed
successfully
Insufficient quality for processing
Projectiles/Casings
Available
Analyzed
Submitted to NIBIN
Other Evidence (e.g., hairs, fibers, tire tracks, etc.)
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Similar/Linked Cases (photocopy and attach additional sheets if necessary)
9. Similar/Linked Case
(1) ViCAP Number: ___________________
Agency Name: ____________________
State/Province: ___________________
Country: _________________________
Case Number: ____________________
Investigator Name: ________________________
Phone Number: ___________________________
Victim’s Full Name: _______________________
Offense Type: ____________________________
Has this case been linked to the instant case through physical evidence, corroborated confession or
conviction?
Yes (specify and explain) ________________________________________________________
________________________________________________________________________________
No
Unknown
(2) ViCAP Number: ____________________
Agency Name: _____________________
State/Province: _____________________
Country: __________________________
Case Number: ______________________
Investigator Name: ________________________
Phone Number: ___________________________
Victim’s Full Name: _______________________
Offense Type: ____________________________
Has this case been linked to the instant case through physical evidence, corroborated confession or
conviction?
Yes (specify and explain) _______________________________________________________
________________________________________________________________________________
No
Unknown
(3) ViCAP Number: ____________________
Agency Name: _____________________
State/Province: _____________________
Country: __________________________
Case Number: ______________________
Investigator Name: ________________________
Phone Number: ___________________________
Victim’s Full Name: _______________________
Offense Type: ____________________________
Has this case been linked to the instant case through physical evidence, corroborated confession or
conviction?
Yes (specify and explain) _______________________________________________________
________________________________________________________________________________
No
Unknown
10. FBI ViCAP Use Only
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Victim Identity
(If your incident has multiple victims, copy the appropriate sections of this
form and provide separate information for each victim).
This is victim ______ of ________ victim(s) in this incident.
#
total
Victim Name
11a. Victim’s primary name:
First
Middle
Last
Suffix
Note: For unidentified human remains cases, enter Jane, John, or Unknown Doe to the required name fields. For sexual assault and
attempted homicide cases, the victim’s name will be masked to any ViCAP Web users outside of your agency, your hub agency (if
applicable), and FBI ViCAP.
11b. Other Names Used (e.g., alias, nickname, maiden name):
First
Middle
Last
Suffix
Case Type
12a. Case Type (select one):
Homicide - Victim Identified
Attempted Homicide
Sexual Assault
Missing Person
Unidentified Human Remains
12b. NCIC Number: ___________________________________________
Crime Types/Motives
13. Based on your experience and the results of this investigation to date, indicate the probable crime
types and/or motives (check all that apply).
Argument/Conflict
Arson
Bias/Hate
Burglary
Carjacking
Child Abduction
(17 years or younger)
Contract
Crime Concealment
Domestic
Drive-by Shooting
Drug-Related
Financial Gain
Gang-Related
Home Invasion
Kidnapping
(18 years or older)
Murder-Suicide
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Police Officer Involved
Revenge
Robbery
Sexual Motivation
Thrill/Amusement
Witness Elimination
Other (specify)_________
Unknown
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Victim's Residence
14. Victim's Residence
Street Address: _______________________
Zip Code: _________________________________
City: _______________________________
Country: __________________________________
County: ____________________________
District / Division / Beat: _____________________
State/Province: _______________________
Latitude / Longitude: ________________________
Identification Numbers
15a. Social Security Number(s): __________________________________________________________
15b. FBI Number: _____________________________________________________________________
15c. State ID Number(s): ________________________________________________________________
15d. City/County ID Number(s): __________________________________________________________
15e. Driver’s License Number(s)/State(s): __________________________________________________
Victim Physical Attributes
Sex
16. Sex (select one):
Male
Female
Unknown
Other (specify) ______________________________
Race
17. Race/Appearance (check all that apply):
American Indian/Alaskan Native
Asian
Black
Hispanic
Native Hawaiian or Other Pacific Islander
White
Other (describe) ______________________________
Unknown
Age, Height, Weight
18. Date(s) of Birth: ____________________________________________________________________
19a. Age (or best estimate) at time of incident: _______________________________________________
19b. Apparent Physical Age (if different from item 19a): _______________________________________
20. Height (or best estimate): _____________________________________________________________
21. Weight (or best estimate): ____________________________________________________________
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Hair
22a. Hair Color (check all that apply):
Black
Blonde
Blue
Brown
Gray
Green
Orange
Pink
Purple
Red
Sandy
White
Other (describe)______________
Unknown
22b. Hair Length (check all that apply):
Bald/Shaved
Balding/Receding
Shorter than Collar Length
Collar Length
Shoulder Length
Longer than Shoulder Length
Other (describe) _______________________
Unknown
Eye Color
23. Eye Color (check all that apply):
Black
Blue
Brown
Gray
Green
Hazel
Other (describe) ________________________
Unknown
Facial Hair
24. Facial Hair (check all that apply):
None
Unshaven/Stubble
Mustache
Goatee
Beard
Other (describe) ________________________
Unknown
Teeth
25. Characteristics of Teeth (check all that apply, indicate tooth number and additional information, if
known):
Dental Records/X-Rays Available
Gaps _______________________________
No Dental Work
Gold/Silver __________________________
Braces ______________________________
Missing (some or all) __________________
Bridge ______________________________
Overbite/Protrusion ____________________
Broken/Chipped ______________________
Restorations/Fillings ___________________
Buck Teeth__________________________
Stained _____________________________
Crooked _____________________________
Underbite ___________________________
Decayed ____________________________
Other (describe) ______________________
Dentures/Partial Plate __________________
Unknown
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Scars/Marks/Tattoos/Piercings
26. Does the victim have any noticeable scars, marks (e.g., pockmarks), tattoos, or body piercings?
Yes (describe in the table below)
No
Unknown
Body Part
Location/Side
Left
Center
Right
Left
Center
Right
Left
Center
Right
Type
Description
Scar/Mark
Tattoo
Piercing
Scar/Mark
Tattoo
Piercing
Scar/Mark
Tattoo
Piercing
Outstanding Feature(s)
27. Does the victim have any outstanding features not reported above (e.g., physical deformity, speech
impediment, accent, odor)?
Yes (describe) _________________________________________________________________
No
Unknown
Clothing, Jewelry, and Possessions
28. Description of clothing, jewelry, glasses, and other items worn by or in possession of victim (include
size, color and brand of clothing for missing and unidentified human remains cases):
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Victimology
Occupation(s)
29. Victim's legal/illegal occupation(s) at time of incident (check all that apply):
Agriculture (farmer, rancher…)
Animal Care (pet groomer, veterinarian...)
Athletics (athlete, coach…)
Automotive (sales, mechanic...)
Aviation (pilot, flight attendant…)
Banking/Finance (accountant, bank teller…)
Bar/Nightclub (bartender, bouncer…)
Business Administration (executive…)
Child Care
Clergy (priest, minister, nun…)
Computer/Information Technician
Construction/Laborer (painter, roofer…)
Consultant
Convenience Store
Criminal (hit man, thief…)
Custodial Worker (janitor, maid…)
Driver - Bus
Driver - Delivery
Driver - Taxi
Driver - Truck
Driver - Other
Drug Sales (illegal)
Educator (teacher, administrator…)
Electronics (maintenance, repair…)
Entertainment (actor, musician…)
Escort Service
Exotic Dancer/Stripper
Fair/Carnival
Fast Food
Fisherman
Gambling (legal or illegal)
Gas Station
Government Employee (non-military)
Grocery Store
Gun Dealer
Health Services (pharmacist, nurse, doctor…)
Homemaker
Hotel/Motel
Insurance
Jeweler/Coin Dealer
Landlord/Property Manager
Landscaper (groundskeeper, gardener…)
Law Enforcement
Legal Profession (lawyer, judge…)
Liquor Sales
Maintenance - Mechanical (appliance repairman…)
Manufacturing (assembly plant worker…)
Migrant Worker
Military
News Media (anchor person, journalist…)
Office Worker (secretary, receptionist…)
Oil Field/Miner
Pawn Shop
Pimp
Prostitution
Protective Services (security, body guard…)
Public Utility (electric/water/cable/telephone)
Radio/TV (on-air personality, producer…)
Railroad Worker
Real Estate
Restaurant/Food Service
Retired
Sales - Retail (merchandise sales, cashier…)
Sales - Traveling
Sales - Other
Salon/Spa Worker (hairstylist, masseuse…)
Self-employed
Service Industry (florist, dry cleaner, travel agent…)
Social Science (social worker, counselor…)
Student
Unemployed
Other (describe) ________________________
Unknown
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Lifestyle Characteristics
30. Victim's general lifestyle characteristics (check all that apply):
Alcohol Abuser
Bisexual
Child (17 years or younger)
Child Molester/Pedophile
Criminal Activity (describe) __________
Drug User/Seller
Elderly
Frequent Internet User
Gambler
Gang Member
Habitual Offender
Heterosexual
Hitchhiker
Homeless/Street Person
Homosexual
Illegal Alien
Mentally Disabled (describe) _____________
Mentally Ill (describe) ___________________
Physically Disabled (describe) ____________
Pimp
Promiscuous
Prostitute
Recluse/Loner
Registered Sex Offender
Retired
Runaway
Student
Transient/Drifter
Transvestite
Other (describe) _______________________
Unknown
Group Affiliation
31. Was the victim a member of, or associated with, any gang, group, or organization?
Yes (describe) __________________________________________________________________
No
Unknown
Marital Status
32. Victim's Marital Status (select one):
Divorced
Married
Separated
Single
Widowed
Other (specify) ______________________
Unknown
Living Arrangements
33. Victim was living with (check all that apply):
Alone
Child(ren)
Friend(s)
Girlfriend/Boyfriend
Parent(s)/Guardian(s)
Relative(s)
Roommate(s)
Spouse/Common-Law
Other (specify) ______________________
Unknown
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Offender Identity
(If your incident has multiple offenders, copy the appropriate sections of
this form and provide separate information for each offender).
This is offender ____ of _______ offender(s) in this incident.
#
total
Offender or Suspect
34. The following information pertains to the (select only one)
Offender (individual determined to be responsible for this crime, whether identified and in
custody or not)
Suspect (individual considered possibly responsible for this crime)
NOTE: From this point forward, this individual will be referred to as offender regardless of whether he/she is
an offender or a suspect.
Offender Status
35. Current Status of This Offender (select one):
Unknown - Not Seen (proceed to question 60)
Unknown - Seen
Identified, Not in Custody
Identified, Status Unknown
In Custody - For This Offense
In Custody - For Another Offense (specify) ___________________________________________
Deceased
Discharged/Paroled from Custody - For This Offense
Date current status began: __________________________
Offender Name
36a. Offender’s primary name:
First
Middle
Last
Suffix
Last
Suffix
36b. Other Names Used (e.g., alias, nickname, maiden name):
First
Middle
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Offender’s Residence
37. Offender’s Residence
Street Address: ___________________________________________________________________
City: __________________________________ County: __________________________________
State/Province: _______________ Zip Code: ________________ Country: _________________
District/Division/Beat: _____________________________________________________________
Latitude/Longitude: _______________________________________________________________
Identification Numbers
38a. Social Security Number(s): __________________________________________________________
38b. FBI Number: _____________________________________________________________________
38c. State ID Number(s): ________________________________________________________________
38d. City/County ID Number(s): __________________________________________________________
38e. Dept. of Corrections Number(s): ______________________________________________________
38f. Driver's License Number(s)/State(s): ___________________________________________________
Offender Physical Attributes
Sex
39. Sex (select one):
Male
Female
Unknown
Other (specify) ______________________________
Race
40. Race/Appearance (check all that apply):
American Indian/Alaska Native
Asian
Black
Hispanic
Native Hawaiian or Other Pacific Islander
White
Other (describe) ______________________
Unknown
Age, Height, Weight
41. Date(s) of Birth: ____________________________________________________________________
42a. Age (or best estimate) at time of incident: _______________________________________________
42b. Apparent Physical Age (if different from item 42a): _______________________________________
43. Height (or best estimate): _____________________________________________________________
44. Weight (or best estimate): ____________________________________________________________
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Hair
45a. Hair Color (check all that apply):
Black
Blonde
Blue
Brown
Gray
Green
Orange
Pink
Purple
Red
Sandy
White
Other (describe) ________________________
Unknown
45b. Hair Length (check all that apply):
Bald/Shaved
Balding/Receding
Shorter than Collar Length
Collar Length
Shoulder Length
Longer than Shoulder Length
Other (describe) ________________________
Unknown
Eye Color
46. Eye Color (check all that apply):
Black
Blue
Brown
Gray
Green
Hazel
Other (describe) _______________________
Unknown
Facial Hair
47. Facial Hair (check all that apply):
None
Unshaven/Stubble
Mustache
Goatee
Beard
Other (describe) ________________________
Unknown
Scars/Marks/Tattoos/Piercings
48. Does the offender have any noticeable scars, marks (e.g., pockmarks), tattoos, or body piercings?
Yes (describe in the table below)
No
Unknown
Body Part
Location/Side
Left
Center
Right
Left
Center
Right
Left
Center
Right
Type
Description
Scar/Mark
Tattoo
Piercing
Scar/Mark
Tattoo
Piercing
Scar/Mark
Tattoo
Piercing
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Outstanding Feature(s)
49. Does the offender have any outstanding features not reported above (e.g., physical deformity, speech
impediment, accent, odor)?
Yes (describe) _________________________________________________________________
No
Unknown
Clothing, Jewelry, and Possessions
50. Description of clothing, jewelry, glasses, and other items worn by or in possession of the offender:
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Offender Lifestyle
Occupation(s)
51. Offender’s legal/illegal occupation(s) (check all that apply):
Agriculture (farmer, rancher…)
Animal Care (pet groomer, veterinarian…)
Athletics (athlete, coach…)
Automotive (sales, mechanic...)
Aviation (pilot, flight attendant…)
Banking/Finance (accountant, bank teller…)
Bar/Nightclub (bartender, bouncer…)
Business Administration (executive…)
Child Care
Clergy (priest, minister, nun…)
Computer/Information Technician
Construction/Laborer (painter, roofer…)
Consultant
Convenience Store
Criminal (hit man, thief…)
Custodial Worker (janitor, maid…)
Driver - Bus
Driver - Delivery
Driver - Taxi
Driver - Truck
Driver - Other
Drug Sales (illegal)
Educator (teacher, administrator…)
Electronics (maintenance, repair…)
Entertainment (actor, musician…)
Escort Service
Exotic Dancer/Stripper
Fair/Carnival
Fast Food
Fisherman
Gambling (legal or illegal)
Gas Station
Government Employee (non-military)
Grocery Store
Gun Dealer
Health Services (pharmacist, nurse, doctor…)
Homemaker
Hotel/Motel
Insurance
Jeweler/Coin Dealer
Landlord/Property Manager
Landscaper (groundskeeper, gardener…)
Law Enforcement
Legal Profession (lawyer, judge…)
Liquor Sales
Maintenance - Mechanical (appliance repairman…)
Manufacturing (assembly plant worker…)
Migrant Worker
Military
News Media (anchor person, journalist…)
Office Worker (secretary, receptionist…)
Oil Field/Miner
Pawn Shop
Pimp
Prostitution
Protective Services (security, body guard…)
Public Utility (electric/water/cable/telephone)
Radio/TV (on-air personality, producer…)
Railroad Worker
Real Estate
Restaurant/Food Service
Retired
Sales - Retail (merchandise sales, cashier…)
Sales - Traveling
Sales - Other
Salon/Spa Worker (hairstylist, masseuse…)
Self-employed
Service Industry (dry cleaner, travel agent...)
Social Science (social worker, counselor…)
Student
Unemployed
Other (describe)__________________________
Unknown
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Lifestyle Characteristics
52. Offender’s general lifestyle characteristics (check all that apply):
Alcohol Abuser
Bisexual
Child (17 years or younger)
Child Molester/Pedophile
Criminal Activity (describe) ________________
Drug User/Seller
Elderly
Frequent Internet User
Gambler
Gang Member
Habitual Offender
Heterosexual
Hitchhiker
Homeless/Street Person
Homosexual
Illegal Alien
Mentally Disabled (describe) ____________
Mentally Ill (describe) _________________
Physically Disabled (describe) ___________
Pimp
Promiscuous
Prostitute
Recluse/Loner
Registered Sex Offender
Retired
Runaway
Student
Transient/Drifter
Transvestite
Other (describe) ______________________
Unknown
Group Affiliation
53. Was the offender a member of, or associated with, any gang, group, or organization?
Yes (describe) __________________________________________________________________
No
Unknown
Offender-Victim Relationships
54. Indicate the offender's relationship to each victim and indicate which victim, if applicable:
Acquaintance ______________________
Boyfriend/Girlfriend _________________
Business Partner ____________________
Care Provider/Babysitter _____________
Child _____________________________
Classmate _________________________
Clergyman ________________________
Co-Worker ________________________
Customer/Client ____________________
Date _____________________________
Employee _________________________
Employer _________________________
Ex-Boyfriend/Ex-Girlfriend ___________
Ex-Spouse _________________________
Friend ____________________________
Gang Member-Fellow ________________
Gang Member-Rival _________________
Landlord __________________________
Medical Provider ____________________
Neighbor __________________________
Parent/Guardian ____________________
Relative ___________________________
Roommate _________________________
Spouse ____________________________
Stranger ___________________________
Student ___________________________
Teacher/Educator ___________________
Tenant ____________________________
Other _____________________________
Unknown__________________________
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Additional Offenses
55. Has your investigation uncovered or identified any evidence that may indicate the offender was
involved in a related offense (e.g., names, addresses, clothing, photographs)?
Yes (describe) __________________________________________________________________
No
Unknown
Offender Timeline (photocopy and attach additional sheets if necessary)
56. If the offender is identified, please enter information on his/her known whereabouts into the table
below. Use additional pages if necessary. This information is valuable when associating/eliminating this
offender in connection with other crimes.
Note: If a timeline has been created for this offender in a separate document, a copy (electronic or
printed) should be provided with this form.
Date From
Date To
Complete Address
Reason
Employed
Resided
Visited
In Custody
In Military-Branch:_______
Employed
Resided
Visited
In Custody
In Military-Branch:_______
Employed
Resided
Visited
In Custody
In Military-Branch:_______
Employed
Resided
Visited
In Custody
In Military-Branch:_______
Employed
Resided
Visited
In Custody
In Military-Branch:_______
Employed
Resided
Visited
In Custody
In Military-Branch:_______
Employed
Resided
Visited
In Custody
In Military-Branch:_______
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Location Description
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Offender Sexual History/Preferences
Note: the following three questions do not necessarily apply to the instant case; they may apply to the offender's overall sexual history or
preferences.
Sex-related Paraphernalia/Devices
57. Did the offender possess sex-related paraphernalia/devices?
Yes (check all that apply below, and describe)
No
Unknown
Belts/Leathers _____________________________________________________________
Condoms/Contraceptive Devices _______________________________________________
Handcuffs _________________________________________________________________
Lubricants/Lotions __________________________________________________________
Masks/Costumes/Clothing ____________________________________________________
Rape Kit/Crime Kit _________________________________________________________
Rubber Dolls/Vagina ________________________________________________________
Sexual Bondage Materials ____________________________________________________
Sexual Devices (e.g., dildos, vibrators) __________________________________________
Torture Devices ____________________________________________________________
Other (specify) ______________________________________________________________
Sex-related Collections
58. Is the offender known to possess sex-related collections (e.g., erotica, pornography)? If so, please fill
in the table below.
Yes
No
Medium
Unknown
Description
Age
Sex
Audio
Image
Text
Video
Other
Unknown
Adult
Child
Unknown
Audio
Image
Text
Video
Other
Unknown
Adult
Child
Unknown
Audio
Image
Text
Video
Other
Unknown
Adult
Child
Unknown
Audio
Image
Text
Video
Other
Unknown
Adult
Child
Unknown
Type
Male
Female
Both
Unknown
Male
Female
Both
Unknown
Male
Female
Both
Unknown
Male
Female
Both
Unknown
LAW ENFORCEMENT SENSITIVE
Page 17
Sexual Non-Violent
Sexual Violent
Non-Sexual
Unknown
Sexual Non-Violent
Sexual Violent
Non-Sexual
Unknown
Sexual Non-Violent
Sexual Violent
Non-Sexual
Unknown
Sexual Non-Violent
Sexual Violent
Non-Sexual
Unknown
Source
Commercial
Homemade
Unknown
Commercial
Homemade
Unknown
Commercial
Homemade
Unknown
Commercial
Homemade
Unknown
LAW ENFORCEMENT SENSITIVE
Sexual Practices & Preferences
59. Indicate the offender's known sexual practices and preferences (check all that apply).
Bestiality
Bisexuality
Bondage Practitioner
Child Molester/Pedophile
Exhibitionist
Group Sex Practitioner
Heterosexuality
Homosexuality
Incest
Masochism
Necrophilia
Promiscuity
Sadism
Transsexualism
Transvestitism
Voyeurism
Other (describe) ______________________
Unknown
Approach to Victim
Offender's Initial Approach
60. What was the offender's initial approach to the victim? (check all that apply)
Unknown
By Deception or Con
Administered Drug (specify) ______________
Asked For/Offered Assistance
Asked Victim to Model/Pose for Photos
Befriended Victim
Caused/Staged Traffic Accident
Engaged Victim in Conversation
Feigned an Injury
Alleged Drug Transaction
Implied Family Emergency or Illness
Internet Communication
Offered Job, Money, Treats, or Toys
Offered Ride/Transportation
Placed or Responded to Advertising
Posed as Authority Figure/Police Officer
Posed as Business Person/Customer
Solicited for Sex
Telephone Contact
Third Person Used to Lure Victim
Wanted to Show Something
Other Deception/Con (describe)
________________________________
By Surprise
Awakened Victim
Forceful Sudden Entry
Lay in Wait - In Building
Lay in Wait - In Vehicle
Lay in Wait - Out of Doors
Threatened with Weapon
Other Surprise (describe)
__________________________________
By Blitz - Direct and Immediate Physical Assault
Choked Victim
Hit Victim w/Hand, Fist, Clubbing Weapon
Physically Overpowered Victim
Shot Victim
Stabbed/Cut Victim
Other Blitz/Assault (describe)
__________________________________
Other Approach (describe) __________________________________________________________
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Victim's Activity
61. The victim was engaged in the following activity at the time he or she was last seen alive or was
initially contacted by the offender (check all that apply):
Babysitting
Driving/Riding in vehicle
Going to/from bar/club/restaurant
Going to/from residence
Going to/from school
Going to/from store
Going to/from work
Hitchhiking
Hunting/Camping/Hiking/Fishing
Involved in a drug transaction
Making a delivery
On a date
On vacation
Outdoor exercising (jogging, biking, etc.)
Playing outside
Prostituting
Selling home, vehicle, etc.
Sleeping
Using Alcohol/Drugs
Other (describe) ______________________
Unknown
Event/Activity in Area
62. Prior to, or at the time of this incident, was there an event in the area (e.g., carnival, convention,
construction project)?
Yes (describe) _________________________________________________________________
No
Unknown
Victim Targeted
63. Has the victim had an experience that would suggest he/she was a targeted victim?
Yes (check all that apply below)
No
Unknown
Calls, Notes, or E-Mails
Feeling that Victim was Watched or Followed
Prowlers or Peeping Incidents
Residential or Vehicle Break-Ins
Theft of Personal Items (clothing, etc.)
Other (describe) ___________________________________________________________
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Dates and Locations
Dates, Times, Locations
64. Enter as much information as possible regarding the dates, times, and locations of this incident. You
must provide at least one Event Site (see next page), date, city or county, and state.
Event Site(s)
See next page
for selections
Victim’s Last
Known
Initial Contact
Murder and/or
Assault
Release and/or
Recovery
Date (or date range)
Time (or time range)
Location Name
(e.g., Pat’s Pub)
Street Address
City
County
State/ Province
Zip Code
Country
District/Division/Beat
Latitude/Longitude
Is there any indication that the offender was familiar with any of the listed locations?
Yes (describe) _________________________________________________________________
No
Unknown
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LAW ENFORCEMENT SENSITIVE
Event Sites
Select from the following list of event sites for each applicable location type, and enter the selected site
number(s) into the table on the previous page. Additional descriptions can also be entered into the table.
If unknown, indicate “Unknown” in the table, rather than a number from the list.
Living Quarters
1. Victim's Residence
2. Offender's Residence
3. Dormitory
4. Multi-Family Dwelling (apt.)
5.
6.
7.
8.
Rest/Nursing Home
Single-Family Dwelling
Transient/Temporary Quarters
Other Living Quarters
Businesses
9. Victim's Workplace
10. Offender's Workplace
11. Bank/ATM
12. Bar/Tavern/Nightclub
13. Casino
14. Convenience Store
15. Daycare Facility
16. Fast Food Restaurant
17. Gas Station
18.
19.
20.
21.
22.
23.
24.
25.
26.
Grocery Store/Market
Hair/Nail/Tan Salon
Liquor Store
Motel/Hotel
Pawn Shop
Restaurant
Shopping Mall/Center/Retail Store
Video Store
Other Business
Transportation
27. Victim's Vehicle
28. Offender's Vehicle
29. Aircraft/Airport
30. Boat/Ship
31. Bus/Bus Stop/Bus Station
32.
33.
34.
35.
36.
Subway/Subway Station
Taxi
Train/Railroad Property
Truck/Truck Stop
Other Transportation
Public Areas/Buildings
37. Athletic Field/Arena
38. Church
39. Circus/Fair/Carnival
40. Government Building
41. Hospital/Medical Facility
42. Military Installation
43.
44.
45.
46.
47.
48.
Office Building
Public Restroom
School/College Campus
Shed/Outbuilding/Barn
Vacant Building
Other Public Area/Building
Outdoor Locations
49. Alley
50. Bridge/Overpass
51. Camping Area
52. Cave/Mine/Quarry
53. Cemetery
54. Commercial Area
55. Construction Area
56. Desert
57. Driveway/Yard
58. Dump/Landfill
59. Embankment
60. Field/Orchard/Farm
61. Mountains/Hills
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
Parking Lot/Garage
Playground/Park
Residential Area
Rest Stop/Area
Road-Gravel/Dirt
Road-Highway/Interstate
Road-Paved/Public
Sidewalk
Trail/Jogging Path
Vacant Lot
Vice Area
Wooded Area/Forest
Other Outdoor Location
Water Locations
75. Beach/Shoreline/Riverbank
76. Canal/Inland Waterway
77. Ditch/Culvert
78. Dock/Boat Ramp
79. Lake/Pond
80. Marsh/Swamp/Bayou
81.
82.
83.
84.
85.
86.
Ocean/Bay
River
Storm Drain/Sewer System
Stream/Creek
Swimming Pool
Other Water Location
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Crime Scene
How Offender Gained Entry
65. If any of the crime scenes were inside a building, indicate how the offender gained entry (check all
that apply).
Forced Entry
Let In by Victim
Lived There/Let Self in
No Sign of Forced Entry
Public Access
Through Unsecured Door/Window
Other (describe) ________________________________________________________________
Unknown
Recorded Events
66. Did the offender record events during the crime (e.g., audio/video/photography)?
Yes (describe) _________________________________________________________________
No
Unknown
Writing or Drawing
67. Was there writing or drawing at any of the crime scenes or on the victim's body?
Yes (describe in table below)
No
Unknown
Writing/Drawing
Description
Location at Scene OR Body Location
Writing Tool
Deliberate, Unusual, or Symbolic Act
68. Is there any indication that a deliberate, unusual, or symbolic act was performed at any of the crime
scenes (e.g., unique objects placed at scene, foreign substance on body)?
Yes (describe) _________________________________________________________________
No
Unknown
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Crime Scenes Altered
69. Were any of the crime scenes altered by the offender in any way or did the offender take other
precautions to avoid identification or apprehension?
Yes (check all that apply below, and describe)
No
Unknown
Administered Drugs to Victim___________________________________________________
Altered Lighting_____________________________________________________________
Burned Scene/Victim's Body____________________________________________________
Cleaned Scene ______________________________________________________________
Cleaned Self________________________________________________________________
Cleaned Victim _____________________________________________________________
Covered Victim's Eyes/Face/Head ________________________________________________
Destroyed/Removed Evidence __________________________________________________
Disabled Phone/Security Device(s) _______________________________________________
Disabled Victim's Vehicle _____________________________________________________
Forced Victim to Bathe or Douche________________________________________________
Gave False Name___________________________________________________________
Increased or Decreased Temperature Setting_________________________________________
Moved Victim from Murder/Assault Area to Release/Recovery Area _______________________
Planted Evidence ___________________________________________________________
Prepared Escape Route Prior to the Assault__________________________________________
Ransacked Scene ___________________________________________________________
Staged Scene _______________________________________________________________
Told Victim Not to Look at Offender______________________________________________
Told Victim Not to Report Incident to Police ________________________________________
Used a Condom ____________________________________________________________
Used a Lookout ____________________________________________________________
Used a Police Scanner Radio ___________________________________________________
Vandalized Scene___________________________________________________________
Wore a Disguise/Mask________________________________________________________
Wore Gloves _______________________________________________________________
Other (specify)_____________________________________________________________
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End of Contact
70. How did the victim/offender contact end?
Escape (offender lost control of victim)
Inadvertent Intervention by Third Party
Offender Left Scene
Release (offender intentionally gave up control of victim)
Rescue/Intervention
Victim's Death
Other (describe) ________________________________________________________________
Unknown
Victim Disposal
71. The offender disposed of the victim's body in the following manner (check one):
Openly Placed to Ensure Discovery
Concealed, Hidden, or Placed to Prevent Discovery
With an Apparent Lack of Concern as to Whether or Not the Victim Was Discovered
Unknown
Victim Positioned
72. Was the victim's body intentionally positioned in an unnatural or unusual way?
Yes (describe) _________________________________________________________________
No
Unknown
Victim Recovery
73. Victim Recovery (check all that apply):
As Skeletal Remains
Buried
Covered
Completely (describe) ______________
Partially (describe) _________________
Face only (describe) ________________
In a Container/Box/Dumpster
In a Vehicle
In Water
Weighted Down (describe) _____________
Not Weighted Down
Wrapped (describe) ______________________
None of the Above
Other (describe) ________________________
In a Bag
In a Bathtub
In a Building
Offender Returned to Site
74. Is there any indication that the offender returned to the victim release/recovery site after the offense?
Yes (describe) __________________________________________________________________
No
Unknown
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Victim Bound
75. At any time, was the victim bound?
Yes (describe in table below)
No
Unknown
Binding Article
Body Part Bound
Hands, Wrists or Arms
Feet, Ankles, or Legs
Hands bound to feet
Arms bound to Torso
Other (specify)
Bindings Selection
Brought to Scene
Found at Scene
Unknown
Bindings Recovery
Left at Scene
Left on Victim
Taken from Scene
Unknown
Bindings Selection
Brought to Scene
Found at Scene
Unknown
Bindings Recovery
Left at Scene
Left on Victim
Taken from Scene
Unknown
____________________
Binding Article
Unknown
Body Part Bound
Hands, Wrists or Arms
Feet, Ankles, or Legs
Hands bound to feet
Arms bound to Torso
Other (specify)
____________________
Unknown
Victim Bound to Object
76. At any time, was the victim bound to an object?
Yes (describe) __________________________________________________________________
No
Unknown
Gag
77. At any time, was a gag placed in/on the victim's mouth?
Yes (describe) __________________________________________________________________
No
Unknown
Blindfold/Hood
78. At any time, was a blindfold/hood placed on/over the victim's eyes?
Yes (describe) __________________________________________________________________
No
Unknown
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Victim Clothing, Property
Victim Clothing
79. Clothing on Victim (post-assault):
Fully Dressed
Partially Dressed
Nude from Waist Up or Breasts/Chest Exposed
Nude from Waist Down or Genital Area Exposed
Nude with Sock(s) and/or Shoe(s)
Dressed without Sock(s) and/or Shoe(s)
Other (describe) ______________________________________________________________
Completely Nude
Unknown
Victim Redressed
80. Was the victim redressed after the assault?
Yes (describe) __________________________________________________________________
No
Unknown
Clothing Intentionally Ripped/Cut
81. Was any of the victim's clothing intentionally ripped or cut by the offender?
Ripped/Torn (describe) ___________________________________________________________
Cut (describe) ___________________________________________________________________
No
Unknown
Items Taken
82. Did the offender take items from the victim and/or any of the crime scenes?
Yes (check all that apply and describe)
No
Backpack/Fannypack/Briefcase ______________
Camera/Camcorder _______________________
Cellphone/Pager/PDA _____________________
Checkbook/Checks _______________________
Cigarettes/Case/Lighter ____________________
Clothing _______________________________
Computer/Laptop ________________________
Credit/Debit/ATM Card ____________________
Driver's License/ID _______________________
Drugs _________________________________
Electronic Equipment _____________________
Electronic Media (CD, VHS, etc.) ____________
Unknown
Food/Drink __________________________
Jewelry ____________________________
Keys/Keychain _______________________
Money _____________________________
Personal Papers/Journal/Datebook _________
Photograph __________________________
Purse/Wallet _________________________
Telephone/Answering Machine ___________
Vehicle (see question 100) _______________
Weapon ____________________________
Other (specify) _______________________
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LAW ENFORCEMENT SENSITIVE
Victim Trauma
Types of Trauma
83a. Indicate the types of trauma inflicted on the victim, including attempted injury (check all that apply).
Where appropriate, indicate the number of wounds.
None
Asphyxiation
Airway Occlusion (choking)
Compressive (crushing)
Drowning
Hanging
Smoke Inhalation
Smothering/Suffocation
Strangulation
Strangulation - Ligature
Strangulation - Manual
Strangulation - Undetermined
Burns (fire)
Crushing Injury
Cutting or Incised Wound(s) - ____ wounds
Drug Injection/Overdose
Explosive Trauma
Exposure
Gunshot Wound(s) - ____ wounds
Distant
Intermediate
Close
Contact
Unknown
Blunt Force Injury(s) - ____ wounds
Minimal
Moderate
Excessive
Brutal
Unknown
Malnutrition/Dehydration
Poisoning
Stab Wound(s) - ____ wounds
Other (specify) ___________ - ____ wounds
Undetermined
Unknown
Cause of Death
83b. For deceased victims only, indicate the medical examiner's/coroner's officially listed primary cause
of death, if known. _____________________________________________________________________
Major Trauma Locations
84. Trauma Locations (check all that apply):
None
Abdomen
Ankle
Anus
Arm(s)
Back
Breast(s)
Buttock(s)
Chest
Ear(s)
Eye(s)
Face
Finger(s)
Foot/Feet
Genitalia
Groin
Hand(s)
Head
Leg(s)
Lip(s)
Neck/Throat
Nipple(s)
Nose
Shoulder(s)
Thigh(s)
Tongue
Other (describe) ______________________
Unknown
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LAW ENFORCEMENT SENSITIVE
Human Bite Marks
85. Was the victim bitten by the offender?
Yes (check all that apply below)
No
Unknown
Undetermined
Note: Choose 'Undetermined' if the victim has bite marks that have not been determined to be (a) human or (b) caused by the offender
Abdomen
Ankle
Anus
Arm(s)
Back
Breast(s)
Buttock(s)
Chest
Ear(s)
Eye(s)
Face
Finger(s)
Foot/Feet
Genitalia
Groin
Hand(s)
Head
Leg(s)
Lip(s)
Neck/Throat
Nipple(s)
Nose
Shoulder(s)
Thigh(s)
Tongue
Other (describe)_______
Unknown
Body Parts Removed
86. Were any of the victim's body parts removed by the offender?
Yes (describe in table below)
No
Unknown
Undetermined
Note: Choose 'Undetermined' if the cause of dismemberment cannot be definitively attributed to the offender (e.g., animal activity,
environmental conditions).
Body Part Removed
Recovery Location
Not Recovered
Recovered at Scene
Recovered Elsewhere _________________________
Unknown
Not Recovered
Recovered at Scene
Recovered Elsewhere _________________________
Unknown
Not Recovered
Recovered at Scene
Recovered Elsewhere _________________________
Unknown
Dismemberment Method
87. Dismemberment Method (check all that apply):
Bitten
Disarticulated
Hacked/Chopped
Ripped/Torn
Cut/Sawed
Other (describe) _________________________________________________________________
Unknown
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LAW ENFORCEMENT SENSITIVE
Unusual Assault/Trauma/Torture
88. Was unusual assault/trauma/torture inflicted upon the victim?
Yes (check all that apply and describe)
No
Unknown
Beat Sexual Areas
With Hands/Fists _____________________________________________________________
With Object ________________________________________________________________
Body Cavities or Genitalia Mutilated_________________________________________________
Body Cavities or Wounds Explored/ Probed ___________________________________________
Body Set on Fire_________________________________________________________________
Burns (cigarette, iron, branding, etc.) ________________________________________________
Cannibalism ____________________________________________________________________
Carving on Victim _______________________________________________________________
Douche/Enema Given to Victim ____________________________________________________
Evisceration ____________________________________________________________________
Hair Cut/Shaved
Head______________________________________________________________________
Pubic _____________________________________________________________________
Other (specify) ______________________________________________________________
Hair Pulled _____________________________________________________________________
Hanged/Suspended _______________________________________________________________
Kicked/Stomped _________________________________________________________________
Patterned Injury _________________________________________________________________
Pierced Body Parts _______________________________________________________________
Pinched
With Device _______________________________________________________________
With Hands ________________________________________________________________
Postmortem Assault
Sexual ____________________________________________________________________
Other (specify)______________________________________________________________
Pulled Body Parts _______________________________________________________________
Puncture/Torture Wounds ________________________________________________________
Shocked
Electrical __________________________________________________________________
Stun Gun/Taser ____________________________________________________________
Skinned _______________________________________________________________________
Slapped/Spanked (with hands) _____________________________________________________
Vampirism ____________________________________________________________________
Vehicular Assault
Dragged By Vehicle _________________________________________________________
Pushed/Shoved/Thrown from Vehicle ___________________________________________
Run Over By Vehicle ________________________________________________________
Victim Defecated/Urinated Upon ___________________________________________________
Whipped/Paddled (with object) _____________________________________________________
Other (specify) __________________________________________________________________
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LAW ENFORCEMENT SENSITIVE
Sexual Activity
This section pertains to the instant case.
Sexual Activity
89a. Is there an indication of sexual activity or attempted sexual activity with the victim?
Yes (check all that apply)
No
Unknown
Anal Penetration
(A)
Penile
(B)
Digital
(C)
(D)
Hand/Fist
Unknown
Vaginal Penetration
(E)
Penile
(F)
Digital
(G)
(H)
Hand/Fist
Unknown
Masturbation
(I)
Offender Masturbated Victim
(J)
Offender Masturbated Self
(K)
(L)
Victim Masturbated Offender
Victim Masturbated Self
Offender Performed Oral Sex on Victim
(M)
Anus
(N)
Penis
(O)
Vagina
Victim Performed Oral Sex on Offender
(P)
Anus
(Q)
Penis
(R)
Vagina
Other Sexual Acts
(S)
Inserted a Foreign Object
(T)
(U)
(V)
(W)
(X)
(Y)
(Z)
(other than a body part) (see Item 89c)
Ejaculated (see Item 90)
Fondled/Groped/Hugged
(AA)
(AB)
Forced Victim to Swallow Semen
Licked
Rubbed Genitalia Against Victim
Simulated Intercourse
Sucked Breasts
Other (describe) _______________
Kissed
Sequence of Acts
89b. List the chronological sequence of sexual acts (or attempted acts) by writing in corresponding letters
of the specific acts listed in item 89a. Repeat use of letters/acts as necessary.
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
13th
14th
15th
16th
17th
18th
19th
20th
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LAW ENFORCEMENT SENSITIVE
Foreign Object Insertion
89c. If there was an indication of foreign object insertion, use the table below to identify the body orifice,
the foreign object, and whether or not the object was left in the victim's body.
Body Orifice
Anus
Mouth
Vagina
Other ____________
Anus
Mouth
Vagina
Other ____________
Foreign Object
Left in Body
Yes
No
Unknown
Yes
No
Unknown
Semen/Ejaculation Location(s)
90. Semen/Ejaculation Location(s) (check all that apply):
None
In Victim's Anus
In Victim's Mouth
In Victim's Vagina
On Victim's Body (describe) _______________________________________________________
On Victim's Clothing (describe) ____________________________________________________
Elsewhere at Scene (describe) ______________________________________________________
Other (describe) _________________________________________________________________
Unknown
Offender’s Reaction to Resistance
91. Indicate the offender's reaction to the types of resistance used by this victim.
Victim # ______________
Offender# _____________
Victim # ______________
Offender# _____________
Victim Resistance
Passive
Physical
Verbal
None
Unknown
Passive
Physical
Verbal
None
Unknown
Offender Reaction
Ceased the Demand
Compromised/Negotiated
Escalated Force
Fled
Ignored
Used Force
Used Threat
Other _____________________________
Unknown
Ceased the Demand
Compromised/Negotiated
Escalated Force
Fled
Ignored
Used Force
Used Threat
Other _____________________________
Unknown
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LAW ENFORCEMENT SENSITIVE
Verbal Activity
92. Was there offender verbal activity?
Yes (check all that apply)
No
Unknown
Apologetic (I'm sorry this had to happen)
Commanding (Take off your clothes, now!)
Complimentary (You are very pretty)
Concern (Are you cold?)
Derogatory (You are so stupid)
Ego-satisfying (Tell me I'm better than your boyfriend)
Inquisitive (Offender asked victim questions)
Knowledgeable (Your two children are upstairs and your husband is not home)
Negotiating (If you stop struggling, I'll loosen the bindings)
Personal (Offender talked about himself/herself)
Profane (Continued use of profane speech)
Reassuring (I'm not going to hurt you, just do as I say)
Self-demeaning (You'd never go out with someone like me)
Threatening (I'll cut you if you don't do as I say)
Other (describe) ____________________________________________________________
Unknown
Offender Dialogue
93. Indicate what the offender said to the victim, in chronological order. Use the offender's exact
words/phrases where possible and include anything the offender directed the victim to say or do.
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Fetishes
94. Did the offender display any obvious fetishes?
Yes (describe) __________________________________________________________________
No
Unknown
Special Props
95. Did the offender use special props during the offense (e.g., red negligee, costume)?
Yes (describe) __________________________________________________________________
No
Unknown
Disrobing
96. Who disrobed whom? (check all that apply):
Victim Already Nude
Victim Disrobed by Offender
Victim Disrobed Self
Victim's Clothing Moved Up/Down/Aside
Victim's Clothing Not Removed
Offender Already Nude
Offender Disrobed by Victim
Offender Disrobed Self
Offender's Clothing Moved Up/Down/Aside
Offender's Clothing Not Removed
Other (describe) ______________________
Unknown
Sexual Dysfunction
97. Did the offender experience a sexual dysfunction?
Yes (describe in table below)
No
Unknown
Offender
# ________
# ________
Dysfunction
Unable to Obtain Erection
Unable to Maintain Erection
Premature Ejaculation
Retarded Ejaculation
Other ________________
Unable to Obtain Erection
Unable to Maintain Erection
Premature Ejaculation
Retarded Ejaculation
Other ________________
Offender Action
Nothing
Forced Victim to Fondle/Masturbate the Offender
Forced Victim to Meet a Specific Condition _________
Forced Victim to Perform Oral Sex
Increased Violence Toward Victim
Masturbated Self
Other _____________________________________
Unknown
Nothing
Forced Victim to Fondle/Masturbate the Offender
Forced Victim to Meet a Specific Condition _________
Forced Victim to Perform Oral Sex
Increased Violence Toward Victim
Masturbated Self
Other _____________________________________
Unknown
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Weapon
98. Was a weapon used, displayed, or threatened during the commission of this crime?
Yes
WEAPON TYPE
(describe below)
No
Unknown
WEAPON SELECTION
Brought
to Scene
Found
at Scene
Unknown
WEAPON RECOVERY
Not
Recovered
Recovered
at Scene
Recovered Elsewhere
(describe)
Unknown
Asphyxial Device:
________________
Bludgeon/Club:
________________
Drug:
________________
Explosive Device:
________________
Fire/Accelerant:
________________
Firearm
Hands or Feet
Ligature:
________________
Pepper Spray
Poison:
________________
Stabbing/Cutting :
________________
Stun Gun
(e.g., Taser)
Vehicle
(see item 100)
Other:
________________
Unknown
99. Firearm/Projectile Characteristics
Firearm Type
(Handgun, Rifle,
Shotgun, etc.)
Firearm Make
Cartridge, Caliber,
or Gauge
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Pellet
Size
# of
Lands/Grooves
Direction
of Twist
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Vehicle (photocopy and attach additional sheets if necessary)
Vehicle Used
100a. Was a vehicle known or suspected to have been used in this incident?
Note: Add the vehicle(s) used in this incident and any other vehicle(s) to which the offender was known to
have access. Indicate within the Distinctive Features text box (question 100l) which vehicle(s) was used in
this incident.
Yes
No
Unknown
Ownership Status
100b. What is the ownership status of the vehicle? (check all that apply)
Owned/Under Control of Offender
Owned/Under Control of Victim
Ownership Status Unknown
Rented/Loaned
Stolen
Vehicle Stolen Date ___________________________________
Street Address________________________________________
City ________________________________________________
County _____________________________________________
State/Province ________________________________________
Zip Code ____________________________________________
Country _____________________________________________
District / Division/ Beat_________________________________
Latitude/Longitude ____________________________________
Not Recovered
Recovered
Vehicle Recovered Date ____________________________
Street Address ____________________________________
City ____________________________________________
County __________________________________________
State/Province ____________________________________
Zip Code ________________________________________
Country _________________________________________
District / Division/ Beat_____________________________
Latitude/Longitude ________________________________
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Identifying Information
100c. License Plate Number: _____________________________________________________________
100d. License State/Province: ____________________________________________________________
100e. License Country: _________________________________________________________________
100f. Vehicle Year (or estimated range): ______________ to ______________
100g. Vehicle Make: ___________________________________________________________________
100h. Vehicle Model: ___________________________________________________________________
100i. Vehicle VIN: _____________________________________________________________________
Body Style
100j. Body Style (check one):
Bike/Moped
Motorcycle
Passenger Car
Pick-Up Truck
RV/Motor Home
Sport Utility
Station Wagon
Tractor-Trailer
Van
Other (specify) _______________________
Unknown
Vehicle Color
100k. Vehicle Color: ___________________________________________________________________
Distinctive Features
100l. Distinctive features of vehicle, if any:
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Narrative
Narrative
101. Provide a comprehensive summary of this case. Include any details important for case comparison
purposes, especially those pertaining to M.O. or unique aspects of the crime. Also, provide as much detail
as possible about the offender.
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Addendum: Additional Investigative Information
Please enter information on any other individual(s) relevant to this crime or to your investigation. This
section is optional and is intended to assist agency case management.
The following information relates to:
Victim #_________
Offender # _______
Crime Scene ________________
Other (specify) ______________
Category
Acquaintance
Associate
Boyfriend/Girlfriend
Coroner
Co-Worker
Employee
Employer
Informant
Neighbor
First Name
Person of Interest
Roommate
Relative (specify) ________________________
Specialist (e.g. Odontologist) (specify) ________
Spouse
Tips Caller
Witness
Other (specify) ___________________________
Middle Name
Last Name
Suffix
Alias/Nickname: _______________________________________________________________________
Telephone Number: ____________________________________________________________________
Email Address: ________________________________________________________________________
Street Address: ________________________________________________________________________
City: _____________________
County: _____________________State/Province: ________________
Zip Code: _________________
Country: ____________________
Social Security Number: ________________________________________________________________
Date of Birth: ________________________________________________________________________
FBI Number: _________________________________________________________________________
Remarks:
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Attachments
The ViCAP Web application supports the upload of text documents, electronic images, and other files
(e.g., Microsoft Office files, small video clips). Each attachment can not exceed 100 MB in size, and only
files with certain extensions can be accepted (list available upon request).
Once imported into ViCAP Web, all attachments are viewable according to case access/user role.
Attachments should be submitted in electronic format, if possible. If only hard copies are available,
attach them to this form and indicate that you would like them scanned and uploaded for you.
Examples of appropriate attachments include items such as suspect/offender photos, timelines, crime
scene photos, autopsy reports and photos, composites, facial reconstructions, bulletins, and vehicle
photos.
Supplemental Information
If at any point during the completion of this form, you were unable to include all pertinent information –
such as similar/linked cases, tattoos or bindings – please include that information in the table below.
Indicate the question number and the question topic, and then enter the information as free text. This
information will be added to the appropriate question when the case is entered into ViCAP Web.
Question #
Topic
Supplemental Information
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File Type | application/pdf |
File Title | Microsoft Word - ViCAP Web Case Submission Form FD676 06032010.doc |
Author | ldmarcolini |
File Modified | 2013-12-18 |
File Created | 2010-06-10 |