Form XX CATCH a Serial Offender Program Entry Details

CATCH A Serial Offender Program Entry Details

OMB Control Number: 0703-0069 Expiration Date: XX/XX/XX

Victim Record Number: (VRN) DSAID Number: (DSAID) Form Printed Date: (Printed Date) Report Manager: (Report Manager)

Mailing Address NCIS Headquarters ATTN: 023E CATCH 27130 Telegraph Road Quantico, VA 22134

Agency Disclosure Notice The public reporting burden for this collection of information, 0704-0553, is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at [email protected]. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

Only one field is needed to submit an entry, however the more information that is provided the more likely the CATCH program will be able to match the suspect to other potential entries or investigations. The most useful information is suspect name, rank and military affiliation; suspect phone number or social media profile; and date and location of the assault.

Suspect Details

First Name

Middle Name

Last Name

Rank/Grade

Unit/Command

Service Member ☐ AIR FORCE ☐ ARMY ☐ COAST GUARD ☐ MARINE CORPS ☐ NAVY ☐ SPACE FORCE ☐ NATIONAL GUARD ☐ CIV

Alias / Nickname

Social Media Name or Link

Phone Number

Email Address

Race

Gender

Current Age

Height Feet Inches

Weight

Eye Color

Hair Color

Visible Scars, Tattoos, Marks

How do you know suspect?

Vehicle Information (Make, Model, Year, Color, State, Plate Number)

Incident Details

Incident Time

Month Day Year

Incident Location (Barracks, Hotel Room, Residence, etc.)

Street Address

City/Installation

State

Zip Code

Country

Additional Details