Submission Method In Person Drop Box Mail/Certified
Other
DPS Laboratory Use Only DPS Laboratory Case #
Complete the following for in person submissions only:
Printed Name (of submitting individual)	Agency
Signature	Date

New Service Request

Additional Evidence	Resubmission	Corrected Copy

DPS Lab Case # (if known)
Submission Information
Agency
Agency Case #
Offense
Offense Date
Offense County
Agency Contact Information
Title / Badge #

Full Name
Agency Address	City, State, Zip
Mark if new address
Business Email	Phone	Fax

Individual (S = Suspect, V = Victim, E = Elimination)

Name (Last, First, Middle, Suffix)	S / V / E	Race	Sex	DOB	State	Driver License #	ID Card #

Conviction Information

Cause #	Court Name and Location	Court #	Date of Conviction	Sentence / Judgement

Description of Evidence Submitted

Agency Item #	Brief Description of Evidence	Quantity